Provider Demographics
NPI:1376554089
Name:JOHNSON, FRANCES P (PT)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:P
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-2604
Mailing Address - Country:US
Mailing Address - Phone:843-899-5374
Mailing Address - Fax:843-899-5376
Practice Address - Street 1:209 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-2604
Practice Address - Country:US
Practice Address - Phone:843-899-5374
Practice Address - Fax:843-899-5376
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ329637388Medicare PIN