| Doctor Name: | DOUGLAS BRENT JOHNSON |
| NPI Number: | 1609895432 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.P.T. |
| License Number: | PT14568 |
| Business Practice Address: | 3440 S Higuera St Suite 120 San Luis Obispo, CA - 934017393 |
| Business Phone Number: | 8054392159 |
| Business Fax Number: | 8054392160 |
| Mailing Address: | Po Box 3070, SHELL BEACH |
| State: | CA |
| Postal Code: | 934483070 |
| Phone Number: | 8054392159 |
| Fax Number: | 8054392160 |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 09/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT14568 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |