Provider Demographics
NPI:1821692385
Name:JOHNSON, AMBERLEE (DPT)
Entity Type:Individual
Prefix:
First Name:AMBERLEE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBERLEE
Other - Middle Name:
Other - Last Name:GRAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3950 RED BANK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3429
Mailing Address - Country:US
Mailing Address - Phone:513-246-8840
Mailing Address - Fax:513-246-8841
Practice Address - Street 1:3950 RED BANK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3429
Practice Address - Country:US
Practice Address - Phone:513-246-8840
Practice Address - Fax:513-246-8841
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-018890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist