Provider Demographics
NPI:1295963874
Name:JOHNSON, CHRISTOPHER STEVEN (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:STEVEN
Last Name:JOHNSON
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 1:415 HWY 95A SOUTH
Mailing Address - Street 2:SUITE C302
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408
Mailing Address - Country:US
Mailing Address - Phone:775-575-1818
Mailing Address - Fax:775-575-1808
Practice Address - Street 1:415 HWY 95A SOUTH
Practice Address - Street 2:SUITE C302
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408
Practice Address - Country:US
Practice Address - Phone:775-575-1818
Practice Address - Fax:775-575-1808
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-2536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist