Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gilissa Johnson

Individual provider Physical Therapist · NPI 1346706546

Gilissa Johnson is a Physical Therapist in Lake Ridge, Virginia. Works from 2 locations. Licensed in Virginia.

Licensed in
VA
In the registry since
2019
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Practice location Address checks out

12825 Minnieville Rd
Lake Ridge, VA 22192-3601
Phone: (703) 971-3701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 35095 Us 19 N Ste 101, Palm Harbor, FL 34684-1968 — (727) 475-5540

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305213488 (VA)

Record details

NPI number1346706546
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 13, 2019
Last updated in NPPESMarch 16, 2023
Certification dateMarch 16, 2023
Mailing address20410 Century Blvd Ste 215, Germantown, MD 20874-1187

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