Provider Demographics
NPI:1275502775
Name:JOHNS, JOSEPH JACOB (PT CSCS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JACOB
Last Name:JOHNS
Suffix:
Gender:M
Credentials:PT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265
Mailing Address - Country:US
Mailing Address - Phone:515-953-5817
Mailing Address - Fax:515-953-1085
Practice Address - Street 1:1050 E ARMY POST RD
Practice Address - Street 2:STE E & F
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315
Practice Address - Country:US
Practice Address - Phone:515-953-5817
Practice Address - Fax:515-953-1085
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAO3113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA37401OtherBCBS