Provider Demographics
NPI:1093922296
Name:JOHNSTON, JAMES WILLIAM (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLIAM
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4086 COUNTY LINE TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44470-9733
Mailing Address - Country:US
Mailing Address - Phone:330-569-5340
Mailing Address - Fax:
Practice Address - Street 1:STATE ROUTE 305
Practice Address - Street 2:HIRAM COLLEGE, PRICE GYMNASIUM
Practice Address - City:HIRAM
Practice Address - State:OH
Practice Address - Zip Code:44234
Practice Address - Country:US
Practice Address - Phone:330-569-5351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-0000732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer