Healthcare Provider Details
I. General information
NPI: 1598863482
Provider Name (Legal Business Name): GINNY JOHNSON PHYSICAL THERAPY, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1221 S CLARKSON ST SUITE 420
DENVER CO
80210-1625
US
IV. Provider business mailing address
182 S HUMBOLDT ST
DENVER CO
80209-2516
US
V. Phone/Fax
- Phone: 303-507-6521
- Fax: 303-813-1467
- Phone: 303-507-6521
- Fax: 303-813-1467
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | 4376 |
| License Number State | CO |
VIII. Authorized Official
Name: MS.
VIRGINIA
ELIZABETH
JOHNSON
Title or Position: PRESIDENT
Credential: MS PT
Phone: 303-507-6521