Individual
BENJAMIN H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3010 W AGUA FRIA FWY, SUITE 102, PHOENIX, AZ 85027-3943
(623) 537-5600
(623) 537-5601
Mailing address
3010 W AGUA FRIA FWY, SUITE 100, PHOENIX, AZ 85027-3943
(623) 537-5600
(623) 537-5601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6763
AZ
2251G0304X
Geriatric Physical Therapist
6763
AZ
2251H1200X
Hand Physical Therapist
6763
AZ
2251P0200X
Pediatric Physical Therapist
6763
AZ
2251S0007X
Sports Physical Therapist
6763
AZ
2251X0800X
Orthopedic Physical Therapist
6763
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162632
—
AZ
01
—
P00618136
RR MEDICARE
AZ
Enumeration date
10/27/2006
Last updated
08/22/2009
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