Provider Demographics
NPI:1851198998
Name:JOHNSON, JESSICA HELEN (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HELEN
Last Name:JOHNSON
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MORNING DOVE LN
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6081
Mailing Address - Country:US
Mailing Address - Phone:772-285-4145
Mailing Address - Fax:
Practice Address - Street 1:525 MORNING DOVE LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6081
Practice Address - Country:US
Practice Address - Phone:772-285-4145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist