Johnson, Lynn R

Johnson, Lynn R is an sole proprietor health care provider with primary practice located at 1611 N Whitley Dr Ste 1A , Fruitland ID 83619-2180. 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, Lynn R can be contacted via phone (208) 452-0021.

Contact Information

Primary practice address
1611 N Whitley Dr Ste 1A Fruitland ID 83619-2180
Phone: (208) 452-0021
Fax: (208) 452-0019
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT178 Idaho

Profile Details

NPI number 1437150059
LBN Legal business name Johnson, Lynn R
Credentials PT; LAT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2005
Last updated Mar 7th, 2013 - about 13 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 1437150059 NPPES
Idaho Other 000010025680 BLUE SHIELD PIN
Idaho Other T4884 BLUE SHIELD PIN

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