Provider Demographics
NPI:1831233196
Name:JOHNSON, CHRISTOPHER L (ATC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SPICER CT
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-5095
Mailing Address - Country:US
Mailing Address - Phone:615-672-3973
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE 190
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-870-1232
Practice Address - Fax:615-865-8285
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44698752255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer