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1710010772
MICHAEL P JOHANSON
NAMPA, ID
NPI
1710010772
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT2163)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
-- MICHAEL P JOHANSON MPT
217 W GEORGIA AVENUE
NAMPA, ID 83686
Phone number: 208-463-3000
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Mailing Address
-- MICHAEL P JOHANSON MPT
217 W GEORGIA SUITE 115
NAMPA, ID 83686
Phone number: 208-463-3000
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