MEDICARE: KRISTEN JOHNSON PT

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	9522	AZ

General Provider Information

NPI Number	:	1649815812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN JOHNSON PT

Provider Business Mailing Address
First Line	:	1932 N WINSTEL BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3329
Country	:	US
Telephone Number	:	216-308-0438
Fax Number	:

Provider Business Practice Location Address
First Line	:	8703 E GOLF LINKS RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-1301
Country	:	US
Telephone Number	:	520-514-1114
Fax Number	:	520-514-2144

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

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	11/12/2019

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Directions to “ KRISTEN JOHNSON PT” Practice Location

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