Provider Demographics
NPI:1528277753
Name:JOHNSTON, MONICA JOY (DPT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:JOY
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 W DUNLAP AVE APT 423
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-3033
Mailing Address - Country:US
Mailing Address - Phone:928-300-5929
Mailing Address - Fax:
Practice Address - Street 1:3411 N 5TH AVE STE 508
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3889
Practice Address - Country:US
Practice Address - Phone:602-264-0443
Practice Address - Fax:602-264-9727
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist