Provider Demographics
NPI:1164077186
Name:JOHNSON, TOI C (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:TOI
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 BANKS EDGE WAY
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-9571
Mailing Address - Country:US
Mailing Address - Phone:614-581-2768
Mailing Address - Fax:
Practice Address - Street 1:13299 SUMMERFIELD WAY
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9251
Practice Address - Country:US
Practice Address - Phone:614-866-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.015757225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist