| NPI | 1386375558 |
|---|---|
| Other Name | GUS JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 6518) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61311447) |
| 225100000X Physical Therapist (Licence: CA 304342) | |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2024-11-22 |