MEDICARE: LEANNE JOHNSTON DPT

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
1	225100000X	Physical Therapist	PTL.0013226	CO

General Provider Information

NPI Number	:	1114123874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNE JOHNSTON DPT

Provider Business Mailing Address
First Line	:	1939 WILMINGTON DR
Second Line	:	SUITE 101
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6404
Country	:	US
Telephone Number	:	970-377-1422
Fax Number	:	970-377-1839

Provider Business Practice Location Address
First Line	:	1939 WILMINGTON DR
Second Line	:	SUITE 101
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6404
Country	:	US
Telephone Number	:	970-377-1422
Fax Number	:	970-377-1839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	11/08/2016

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Directions to “ LEANNE JOHNSTON DPT” Practice Location

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