Provider Demographics
NPI:1770781858
Name:JOHNSON, THOMAS H SR (RRT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:JOHNSON
Suffix:SR
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 ONEAL ROAD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65610
Mailing Address - Country:US
Mailing Address - Phone:417-744-4257
Mailing Address - Fax:417-744-4257
Practice Address - Street 1:525 ONEAL ROAD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MO
Practice Address - Zip Code:65610
Practice Address - Country:US
Practice Address - Phone:417-744-4257
Practice Address - Fax:417-744-4257
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000240282279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics