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Individual

MICHAEL A. JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
71 SILHAVY RD, SUITE 121, VALPARAISO, IN 46383-4484
(219) 462-0576
(219) 462-0216
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 795-6106

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011255A
IN
225100000X
Physical Therapist
4088
SC
225100000X
Physical Therapist
PT.012408
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
TH1692
SC
Enumeration date
05/16/2006
Last updated
09/16/2014
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