Provider Demographics
NPI:1912062944
Name:JOHNS, CARIN (DPT)
Entity Type:Individual
Prefix:
First Name:CARIN
Middle Name:
Last Name:JOHNS
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 1:4666 RUTLAND DUNN TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-2254
Mailing Address - Country:US
Mailing Address - Phone:608-443-8590
Mailing Address - Fax:
Practice Address - Street 1:990 JANESVILLE ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-2954
Practice Address - Country:US
Practice Address - Phone:608-835-5373
Practice Address - Fax:608-835-0373
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10486-024314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10486-024OtherPHYSICAL THERAPY LICENSE