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Individual

NICHOLAS ROBERT JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1900 CONVERSE AVE STE B, CHEYENNE, WY 82001-4112
(307) 514-2411
(307) 514-2392
Mailing address
PO BOX 1790, DOUGLAS, WY 82633-1790
(307) 358-9464
(307) 358-9330

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-04736
KS
225100000X
Physical Therapist
Primary
1858
WY

Other

Enumeration date
02/20/2014
Last updated
06/27/2019
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