MEDICARE: MEGAN 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
1	225100000X	Physical Therapist	070023831	IL

General Provider Information

NPI Number	:	1437906971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN JOHNSON

Provider Business Mailing Address
First Line	:	2715 W 25TH AVE UNIT 19
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5082
Country	:	US
Telephone Number	:	715-305-0594
Fax Number	:

Provider Business Practice Location Address
First Line	:	2715 W 25TH AVE UNIT 19
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5082
Country	:	US
Telephone Number	:	715-305-0594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2024
Last Update Date	:	11/15/2024

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Directions to “ MEGAN JOHNSON ” Practice Location

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