Johnson, Carl Austin

Johnson, Carl Austin is an individual health care provider with primary practice located at 285 W Francis Blackfoot Physical Therapy, Blackfoot ID 83221. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Johnson, Carl Austin can be contacted via phone (208) 785-0123.

Contact Information

Primary practice address
285 W Francis Blackfoot Physical Therapy Blackfoot ID 83221
Phone: (208) 785-0123
Fax: (208) 782-1885
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT944 Idaho

Profile Details

NPI number 1912063652
LBN Legal business name Johnson, Carl Austin
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912063652 NPPES
Idaho Other T4629 BLUE CROSS

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