Matthew Johnson
Individual provider Active NPI Occupational Therapist · Ortonville, MN
NPI 1124367354 · NPPES record last updated Feb 7, 2013
Key facts
- NPI
- 1124367354
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 104177 (MN)
- Practice address
- 309 Washington Ave
Ortonville, MN 56278-1357 - Phone
- (320) 839-4271
- Fax
- (320) 839-4196
- NPI assigned
- Feb 7, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104177 | MN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104177 | MN | Yes |
Addresses
Primary practice location
309 Washington Ave
Ortonville, MN 56278-1357
Mailing address
309 Washington Ave
Ortonville, MN 56278-1357
Phone (320) 839-4271
Other providers in Ortonville, MN
- Chance Haugen
- Kelsey Marie Henningson-Kaye
- Natasha Hynnek
- Independent School District 62
- Cathleen Mary Dolores Janitschke
- Haley Jones
- Cheryl E Jurgens
- Sheree S Keller
- Alexandra King
- Suzanne Kleindl
All providers in Ortonville, MN · Occupational Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.