Provider Demographics
NPI:1588198824
Name:JOHNSON, ERICA BEIDLER (PHD, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:BEIDLER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:BEIDLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LAT, ATC
Mailing Address - Street 1:600 FORBES AVE
Mailing Address - Street 2:RANGOS HEALTH SCIENCES BUILDING 118
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-3016
Mailing Address - Country:US
Mailing Address - Phone:412-396-4391
Mailing Address - Fax:
Practice Address - Street 1:600 FORBES AVE
Practice Address - Street 2:RANGOS HEALTH SCIENCES BUILDING 118
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-3016
Practice Address - Country:US
Practice Address - Phone:412-396-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0064172255A2300X
MI26010012482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer