Johnson, Thomas Dale
Johnson, Thomas Dale is an sole proprietor health care provider with primary practice located at 1930 E Southern Ave , Tempe AZ 85282-7518. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as his primary health care specialty. Johnson, Thomas Dale can be contacted via phone (480) 456-0719.Contact Information
Primary practice address
1930 E Southern Ave
Tempe AZ 85282-7518
Phone: (480) 456-0719
Fax: (480) 456-0163
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 3282 | Arizona |
Profile Details
| NPI number | 1225184047 |
|---|---|
| LBN Legal business name | Johnson, Thomas Dale |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 26th, 2007 |
| Last updated | May 11th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225184047 | NPPES |
| Arizona | MEDICAID | 390279 |
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