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General NPI Number Information
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NPI Number | 1184216574
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Entity Type | Individual
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Provider Name | TRESSA JOHNSTON PT,DPT
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Gender | Female
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 02/07/2021
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Provider Practice Location Address
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Address Line | 365 W 1550 N STE H
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City | LAYTON
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State | UT
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Zip | 84041-2279
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Country | US
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Telephone | 801-618-7903
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Fax |
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Provider Business Mailing Address
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Address Line | 525 N MAIN ST
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City | MANTUA
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State | UT
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Zip | 84324-4342
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Country | US
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Telephone | 435-225-0625
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Fax |
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 286651-2401
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License Number State | UT
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