Individual
MR. DANIEL ALAN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
115 S WASHINGTON ST, OTTUMWA, IA 52501-2531
(641) 682-8171
(641) 682-9054
Mailing address
115 S WASHINGTON ST, OTTUMWA, IA 52501-2531
(641) 682-8171
(641) 682-9054
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001368
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665349
—
IA
01
—
20-8717967
IOWA GROUP TAX ID#
IA
01
—
6-6534
BCBS GROUP #
IA
Enumeration date
06/18/2009
Last updated
06/18/2009
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