Provider Demographics
NPI:1518172709
Name:JOHNSON, BARBARA J (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 RIVENOAK CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2375
Mailing Address - Country:US
Mailing Address - Phone:734-741-8858
Mailing Address - Fax:734-741-8858
Practice Address - Street 1:2270 RIVENOAK CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2375
Practice Address - Country:US
Practice Address - Phone:734-741-8858
Practice Address - Fax:734-741-8858
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501003609OtherPHYICAL THERAPY LICENSE