Provider Demographics
NPI:1255092631
Name:ENGLAND, JOHNNY LEE (DPT)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:LEE
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1903
Mailing Address - Country:US
Mailing Address - Phone:270-590-9697
Mailing Address - Fax:
Practice Address - Street 1:2365 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4144
Practice Address - Country:US
Practice Address - Phone:270-842-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA04322225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant