Provider Demographics
NPI:1164573408
Name:JOHANN, CHRISTOPHER ROBERT (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:JOHANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7987 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2715
Mailing Address - Country:US
Mailing Address - Phone:720-845-6880
Mailing Address - Fax:720-845-6884
Practice Address - Street 1:7987 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2715
Practice Address - Country:US
Practice Address - Phone:720-845-6880
Practice Address - Fax:720-845-6884
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203572225100000X
GAPT009000225100000X
CO13776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA204045631Medicaid
GA65BBFCRMedicare PIN