Paul F Johnston, PTA
Individual provider Active NPI Physical Therapy Assistant · Prairie Du Chien, WI
NPI 1629128129 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629128129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 328019 (WI)
- Practice address
- 705 E Taylor St
Prairie Du Chien, WI 53821-2110 - Phone
- (608) 357-2000
- Fax
- (608) 357-2254
- NPI assigned
- Jan 10, 2007
- 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 |
|---|---|---|---|
| 328019 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 328019 | WI | Yes |
Addresses
Primary practice location
705 E Taylor St
Prairie Du Chien, WI 53821-2110
Mailing address
705 E Taylor St
Prairie Du Chien, WI 53821-2110
Phone (608) 357-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40368900 | Medicaid | WI |
Other providers in Prairie Du Chien, WI
- Ibn Sina Healthcare
- Interstate EMS of Prairie Du Chien, Inc.
- Iowa Hearing Associates LLC
- Dixie L Jackson
- Alexa Marie Jacobsen
- James C Jordan
- Kurt J Jorgensen
- Lynette R Kansier
- Adam Keenan
- Crystal Jean Keeney
All providers in Prairie Du Chien, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.