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1023152543
GWANETIA M JOHNSON
COLUMBIA, SC
NPI
1023152543
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: SC 1960)
Enumeration Date
2007-02-17
Last Update Date
2007-07-08
Business Address
-- GWANETIA M JOHNSON PTA
2601 FOREST DR
COLUMBIA, SC 29204-2363
Phone number: 803-765-7127
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Mailing Address
-- GWANETIA M JOHNSON PTA
504 CAMBOUT ST
COLUMBIA, SC 29210-7121
Phone number: 803-238-8788
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