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Organization
RICHARD JOHANSEN PHYSICAL THERAPY INC
Active
Organization
RICHARD JOHANSEN PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A JOHANSEN PHYSICAL THERAPIST (PRESIDENT)
(352) 372-8970
Entity
Organization
Contact information
Practice address
17 NW 33RD CT, GAINESVILLE, FL 32607-2552
(352) 372-8790
(352) 372-8908
Mailing address
17 NW 33RD CT, GAINESVILLE, FL 32607-2552
(352) 372-8790
(352) 372-8908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y5403
BCBS
FL
Enumeration date
10/03/2005
Last updated
04/02/2008
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