Healthcare Provider Details

I. General information

NPI: 1710811906
Provider Name (Legal Business Name): AIREYAN JOHNSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 S GREENWOOD ST
OLATHE KS
66215-4898
US

IV. Provider business mailing address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 877-407-3422
  • Fax: 877-407-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP055903T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: