Provider Demographics
NPI:1144498908
Name:JOHNSON, SARA ANNE (DPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:JOHNSON
Suffix:
Gender:F
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:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1478
Mailing Address - Country:US
Mailing Address - Phone:615-591-6590
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:151 ADAMS LN
Practice Address - Street 2:SUITE 11
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3598
Practice Address - Country:US
Practice Address - Phone:615-773-1561
Practice Address - Fax:615-773-1564
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6798942225100000X
TN8970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6798942OtherSTATE LICENSE
AL6798942OtherSTATE LICENSE