Provider Demographics
NPI:1801409297
Name:JOHNSON, ANDREW COLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:COLE
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 HIGDON FERRY RD STE G
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6904
Mailing Address - Country:US
Mailing Address - Phone:501-525-2273
Mailing Address - Fax:501-525-1773
Practice Address - Street 1:1635 HIGDON FERRY RD STE G
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6904
Practice Address - Country:US
Practice Address - Phone:501-525-2273
Practice Address - Fax:501-525-1773
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist