Individual
JUSTIN INDIGO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1300 EGG HARBOR RD STE 152, STURGEON BAY, WI 54235-1248
(920) 746-0410
Mailing address
1655 SYCAMORE ST APT 2, STURGEON BAY, WI 54235-3811
(847) 873-4626
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14964-24
WI
Other
Enumeration date
04/10/2020
Last updated
08/05/2024
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