Megan Raeann Johnson

Individual provider Active NPI Physical Therapy Assistant · North Mankato, MN

NPI 1831884055 · NPPES record last updated Apr 5, 2023

Key facts

NPI
1831884055
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A2753 (MN)
Practice address
1575 Hoover Dr
North Mankato, MN 56003-2667
Phone
(507) 387-2037
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A2753MNMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A2753 MN Yes

Addresses

Primary practice location

1575 Hoover Dr
North Mankato, MN 56003-2667

Mailing address

1575 Hoover Dr
North Mankato, MN 56003-2667
Phone (507) 387-2037

Other providers in North Mankato, MN

All providers in North Mankato, MN · Physical Therapy Assistant in Minnesota

Sources for this page

Verify at the official NPI Registry.