Provider Demographics
NPI:1396069571
Name:JOHNSTON, CHRISTOPHER ANTHONY (DPT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:777 S NEW BALLAS RD
Mailing Address - Street 2:STE 218E
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8718
Mailing Address - Country:US
Mailing Address - Phone:314-991-2562
Mailing Address - Fax:314-991-2593
Practice Address - Street 1:939 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2910
Practice Address - Country:US
Practice Address - Phone:636-240-7000
Practice Address - Fax:636-240-7513
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010003221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist