Provider Demographics
NPI:1457621179
Name:JOHNSON, VICTOR WILLIAM (MS RCEP)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:WILLIAM
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MS RCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:MC 0960
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-7822
Mailing Address - Fax:303-436-7739
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:MC 0960
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-7822
Practice Address - Fax:303-436-7739
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist