Individual
MICHEAL P JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1311 WAKARUSA DR STE 1000, LAWRENCE, KS 66049-1741
(785) 749-1300
(785) 749-4746
Mailing address
1311 WAKARUSA DR STE 1000, LAWRENCE, KS 66049-1741
(785) 749-1300
(785) 749-4746
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01856
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1401856
225100000X
KS
Enumeration date
04/15/2022
Last updated
04/15/2022
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