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General NPI Number Information
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NPI Number | 1952425662
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Entity Type | Individual
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Provider Name | JAN J JOHNSON PT
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1878 MOUNTAIN RD STE 1
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City | STOWE
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State | VT
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Zip | 05672-4775
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Country | US
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Telephone | 802-253-2273
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Fax | 802-253-7754
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Provider Business Mailing Address
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Address Line | 220 THOMAS LN
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City | STOWE
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State | VT
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Zip | 05672-5060
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Country | US
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Telephone | 802-253-8869
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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 | 040-0002878
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License Number State | VT
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