Doctor Name: | WAYNE A JOHANSEN |
NPI Number: | 1629064126 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 987 |
Business Practice Address: | 626 14th St Baraboo, WI - 539131535 |
Business Phone Number: | 6083562334 |
Business Fax Number: | 6083562636 |
Mailing Address: | Po Box 31, BARABOO |
State: | WI |
Postal Code: | 539130031 |
Phone Number: | 6083562334 |
Fax Number: | 6083562636 |
NPI Enumeration Date: | 09/21/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 987 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |