Tiffany J Johnson, PTA
Individual provider Active NPI Physical Therapy Assistant · Summit, WI
NPI 1376893263 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1376893263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 36500 Aurora Dr
Summit, WI 53066-4899 - Phone
- (262) 434-2600
- NPI assigned
- Sep 18, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Yes |
Addresses
Primary practice location
36500 Aurora Dr
Summit, WI 53066-4899
Mailing address
N3117 Schmidt Rd
Jefferson, WI 53549-9741
Phone (920) 285-4475
Other providers in Summit, WI
- Kimberly Couture Ireland
- Ahmed Ismail
- Zachary A Jaffa
- Jennifer Lynn Johnson
- Jessy Charles-James Johnson
- Vijay Johnson
- Iqbal M Kahloon
- Katherine M Karczewski
- Michael P Kefer
- Maggie M Keller
All providers in Summit, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.