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NPI Code Detail

MEDICARE: TERESA ANNE JOHNSON

MEDICARE: TERESA ANNE JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist919MT

General Provider Information

NPI Number : 1033690136
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA ANNE JOHNSON
Provider Business Mailing Address
First Line : 425 1ST AVE N
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-2507
Country : US
Telephone Number : 406-454-3883
Fax Number :
Provider Business Practice Location Address
First Line : 425 1ST AVE N
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-2507
Country : US
Telephone Number : 406-454-3883
Fax Number : 406-452-3235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2018
Last Update Date : 08/27/2018

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Directions to “ TERESA ANNE JOHNSON ” Practice Location

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