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Individual
MR. MICHAEL L JOHNSON
Active
Individual
MR. MICHAEL L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
50-039
WI
246Z00000X
Other Specialist/Technologist
1853-046
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1853-046
CERT MASSAGE THERAPIST
WI
01
—
50-039
ATHLETIC TRAINER
WI
Enumeration date
07/20/2006
Last updated
05/21/2014
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