Provider Demographics
NPI:1659981967
Name:JOHNSTON, CHRISTOHER (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTOHER
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-8696
Mailing Address - Country:US
Mailing Address - Phone:304-680-3201
Mailing Address - Fax:
Practice Address - Street 1:3125 SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8696
Practice Address - Country:US
Practice Address - Phone:304-680-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-44652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer