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Contact Information

FRED K JOHNSON, DPT
325 MDG 340 MAGNOLIA CIRCLE
TYNDALL AFB, FL32403
 Phone: 850-283-7019
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for FRED K JOHNSON · (Male)

NPI # 1689826554
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 10/22/2008
Last updated 07/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PT25177
  • NY License # 029708
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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