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General NPI Number Information
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NPI Number | 1114981784
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Entity Type | Individual
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Provider Name | MICHAEL ROBERT JOHNSON DSCPT, OCS
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | KELLER ARMY COMMUNITY HOSPITAL, ARVIN GYMNASIUM 900 WASHINGTON ROAD
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City | WEST POINT
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State | NY
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Zip | 10996
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Country | US
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Telephone | 845-938-3324
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Fax | 845-938-8114
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Provider Business Mailing Address
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Address Line | 578A BENEDICT RD
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City | WEST POINT
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State | NY
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Zip | 10996-1205
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Country | US
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Telephone | 845-938-3067
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Fax | 845-938-8114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 039400-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2799
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License Number State | OR
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