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General NPI Number Information
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NPI Number | 1801248158
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Entity Type | Individual
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Provider Name | SUSAN JOHNSTON BCTMB LMT CMT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 4234 N WINFIELD SCOTT PLZ SUITE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3944
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Country | US
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Telephone | 480-366-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 4234 N WINFIELD SCOTT PLZ SUITE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3944
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Country | US
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Telephone | 480-366-4000
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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 | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | MT-14430
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License Number State | AZ
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