Individual
MR. GLENN A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
808 E JUSTIN DR, SIOUX FALLS, SD 57108-4646
(605) 331-5442
Mailing address
808 E JUSTIN DR, SIOUX FALLS, SD 57108-4646
(605) 331-5442
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0165
SD
225100000X
Physical Therapist
2909
MN
225100000X
Physical Therapist
3511
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5830370
—
SD
Enumeration date
01/26/2008
Last updated
01/26/2008
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