IndividualActive
Jaquan Johnson, PTA
NPI 1487484408 · Physical Therapy Assistant · Lansing, KS
Provider details
- NPI number
- 1487484408
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- License
- 14-04141 (KS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1004 Progress Dr Ste 100
Lansing, KS 66043-6323
Phone: (913) 351-3586
Approximate (ZIP-level) locationGet directions
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Registry dates
- Enumerated
- 2024-08-05
- Last updated
- 2024-08-05
- Certified
- 2024-08-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.