Provider Demographics
NPI:1114911682
Name:JOHNSTON, CHRISTOPHER ALLEN (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 LANGSTON DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-8081
Mailing Address - Country:US
Mailing Address - Phone:812-626-5397
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF SOUTHERN INDIANA
Practice Address - Street 2:8600 UNIVERSITY BLVD
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712
Practice Address - Country:US
Practice Address - Phone:812-465-1298
Practice Address - Fax:812-465-7094
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000598A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer