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NPI Code Detail

MEDICARE: MARYANN S JOHNSON PT

MEDICARE: MARYANN S JOHNSON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2886MN

General Provider Information

NPI Number : 1114015997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN S JOHNSON PT
Provider Business Mailing Address
First Line : 3500 AMERICAN BLVD W STE 300
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-4442
Country : US
Telephone Number : 952-512-5600
Fax Number :
Provider Business Practice Location Address
First Line : 4040 RADIO DR
Second Line :
City : WOODBURY
State : MN
Zip : 55129-3237
Country : US
Telephone Number : 651-439-8807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 12/24/2025

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Directions to “ MARYANN S JOHNSON PT” Practice Location

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