Provider Demographics
NPI:1295007797
Name:JOHNEY, UNKNOWN ANUP (PT)
Entity Type:Individual
Prefix:MR
First Name:UNKNOWN
Middle Name:ANUP
Last Name:JOHNEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 ROBINWOOD RD
Mailing Address - Street 2:APT C
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1622
Mailing Address - Country:US
Mailing Address - Phone:704-466-4694
Mailing Address - Fax:
Practice Address - Street 1:2650 COURT DRIVE
Practice Address - Street 2:COMPLEAT REHAB AND SPORTS THERAPY
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054
Practice Address - Country:US
Practice Address - Phone:704-824-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13332225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist