Individual
NICHOLAS JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT, CSCS
Contact information
Practice address
4550 N BLACK CANYON HWY, PHOENIX, AZ 85017-3714
(602) 995-2643
Mailing address
2818 E DARROW ST, PHOENIX, AZ 85042-6065
(530) 410-5649
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-31312
AZ
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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