Provider Demographics
NPI:1679149405
Name:JOHNSON, RACHEL CLARIS LEEANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:CLARIS LEEANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 BAYLOR CT
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-9007
Mailing Address - Country:US
Mailing Address - Phone:918-907-1028
Mailing Address - Fax:
Practice Address - Street 1:1223 SWAN DR
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-5037
Practice Address - Country:US
Practice Address - Phone:918-336-8500
Practice Address - Fax:918-336-8519
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60012081P0010X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine