Individual
MR. JEFFREY A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2517 7TH AVE S, SUITE A1, GREAT FALLS, MT 59405-3032
(406) 771-0777
Mailing address
2517 7TH AVE S, SUITE A1, GREAT FALLS, MT 59405-3032
(406) 771-0777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
591PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3400408
—
MT
01
—
P00062292
RAILROAD MEDICARE
MT
Enumeration date
01/11/2007
Last updated
07/08/2007
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