Provider Demographics
NPI:1548440233
Name:JOHNSON, ALEXIA LEIN (RRT)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:LEIN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-2744
Mailing Address - Country:US
Mailing Address - Phone:307-277-2869
Mailing Address - Fax:
Practice Address - Street 1:2160 FRANCES ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-5664
Practice Address - Country:US
Practice Address - Phone:307-277-2869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY313227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered