Organization
WAYNE A JOHANSEN
Active
Organization
WAYNE A JOHANSEN
Active
Other names
PHYSICAL THERAPY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE A JOHANSEN (OWNER/PHYSICAL THERAPIST)
(608) 356-2334
Entity
Organization
Contact information
Practice address
626 14TH ST, BARABOO, WI 53913-1535
(608) 356-2334
(608) 356-2636
Mailing address
PO BOX 31, BARABOO, WI 53913-0031
(608) 356-2334
(608) 356-2636
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
987
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40414400
—
WI
Enumeration date
04/10/2007
Last updated
06/17/2008
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