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General NPI Number Information
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NPI Number | 1629940077
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Entity Type | Individual
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Provider Name | ABIGAIL J JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 350 23RD AVE E STE 103
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City | WEST FARGO
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State | ND
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Zip | 58078-7402
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Country | US
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Telephone | 701-639-2769
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 9TH ST E STE 401
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City | WEST FARGO
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State | ND
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Zip | 58078-3381
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Country | US
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Telephone | 701-364-2739
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2956
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License Number State | ND
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