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NPI Code Detail

MEDICARE: CRISTOPHER JOHNSON PTA

MEDICARE: CRISTOPHER JOHNSON PTA
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
1225200000XPhysical Therapy AssistantA0872NV

General Provider Information

NPI Number : 1275994121
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTOPHER JOHNSON PTA
Provider Business Mailing Address
First Line : 9001 CASTLEDOWNS ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-4984
Country : US
Telephone Number : 702-303-9663
Fax Number :
Provider Business Practice Location Address
First Line : 6351 N FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-2300
Country : US
Telephone Number : 702-515-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2016
Last Update Date : 03/18/2016

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Directions to “ CRISTOPHER JOHNSON PTA” Practice Location

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