| Doctor Name: | MICHAEL ROBERT JOHNSON |
| NPI Number: | 1114981784 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DSCPT, OCS |
| License Number: | 2799 |
| Business Practice Address: | Keller Army Community Hospital, Arvin Gymnasium 900 Washington Road West Point, NY - 10996 |
| Business Phone Number: | 8459383324 |
| Business Fax Number: | 8459388114 |
| Mailing Address: | 578a Benedict Rd, WEST POINT |
| State: | NY |
| Postal Code: | 109961205 |
| Phone Number: | 8459383067 |
| Fax Number: | 8459388114 |
| NPI Enumeration Date: | 04/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 2799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |