Provider Demographics
NPI:1164573408
Name:JOHANN, CHRIS (DPT)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:JOHANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S QUEBEC ST
Mailing Address - Street 2:BLDG 600, STE 215
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7144
Mailing Address - Country:US
Mailing Address - Phone:303-341-0369
Mailing Address - Fax:303-341-0866
Practice Address - Street 1:200 S QUEBEC ST
Practice Address - Street 2:BLDG 600, SUITE 215
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7144
Practice Address - Country:US
Practice Address - Phone:303-341-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13776225100000X
VA2305203572225100000X
GAPT009000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA204045631Medicaid
GA65BBFCRMedicare PIN