Provider Demographics
NPI:1861585606
Name:JOHNSON, DEANN RACHEL (PT)
Entity type:Individual
Prefix:MS
First Name:DEANN
Middle Name:RACHEL
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 SAGEBRUSH LN STE 1
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59722-2320
Mailing Address - Country:US
Mailing Address - Phone:406-846-7770
Mailing Address - Fax:406-846-7771
Practice Address - Street 1:124 OAK ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2335
Practice Address - Country:US
Practice Address - Phone:406-846-7770
Practice Address - Fax:406-846-7771
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT 1213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist