Organization
NLJ PHYSICAL THERAPY CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEAL LORN JOHNSON LICENSED PHYSICAL TH (OWNER PRESIDENT OF CLINIC)
(906) 774-3779
Entity
Organization
Contact information
Practice address
901 PYLE DRIVE, KINGSFORD, MI 49802-4452
(906) 774-3779
(906) 774-6712
Mailing address
901 PYLE DRIVE, KINGSFORD, MI 49802-4452
(906) 774-3779
(906) 774-6712
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4326024
WI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5501003258
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009687
PREFERRED ONE
—
01
—
380747012
TRICARE NORTH
—
01
—
650012048
RAILROAD MEDICARE
—
01
—
650B257010
BCBS OF MICH
—
Enumeration date
08/03/2006
Last updated
03/08/2011
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