Most Relevant Information
Provider Data
| NPI Number: | 1003030909 |
| Provider Name: | JONATHAN DAVID JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | AOO558 |
Most Important Dates
| Enumeration Date: | 04/12/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2327 N CHARLES ST
BALTIMORE
MD
212185128
Practice Location Phone/Fax
| Phone: | 4108898500 |
| Fax: | 4108890696 |
Provider Mailing Location
45 STONEWAY PL
BALTIMORE
MD
212364808
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |