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1407289622
BRAD A JOHANSON
TUCKER, GA
NPI
1407289622
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: GA PT011168)
Enumeration Date
2013-08-12
Last Update Date
2015-10-30
Business Address
Dr. BRAD A JOHANSON DPT
2191 NORTHLAKE PKWY BUILDING 11 SUITE 31
TUCKER, GA 30084-4166
Phone number: 770-491-6004
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Mailing Address
Dr. BRAD A JOHANSON DPT
3300 NORTHEAST NEEXPY 8
ATLANTA, GA 30341-3321
Phone number: 770-500-3848
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