Provider Demographics
NPI:1932406154
Name:JUSTICE, CATHERINE ELIZABETH JOHNSON (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH JOHNSON
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4999 FRANCE AVE S
Mailing Address - Street 2:SUITE 235
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1703
Mailing Address - Country:US
Mailing Address - Phone:612-333-1133
Mailing Address - Fax:612-333-0033
Practice Address - Street 1:4999 FRANCE AVE S
Practice Address - Street 2:SUITE 235
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1703
Practice Address - Country:US
Practice Address - Phone:612-333-1133
Practice Address - Fax:612-333-0033
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8654225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist