Doctor Name: | MICHAEL TODD JOHNSON |
NPI Number: | 1033379474 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CMT |
License Number: | 419148-00 |
Business Practice Address: | 26 W Grand Ave Chippewa Falls, WI - 547292415 |
Business Phone Number: | 7157234451 |
Business Fax Number: | 7157234451 |
Mailing Address: | 26 W Grand Ave, CHIPPEWA FALLS |
State: | WI |
Postal Code: | 547292415 |
Phone Number: | 7157234451 |
Fax Number: | 7157234451 |
NPI Enumeration Date: | 06/10/2008 |
NPI Last Update Date: | 06/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 419148-00 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |