Johnson, Mary Susan

Johnson, Mary Susan is an individual health care provider with primary practice located at 18000 W Bluemound Rd Ste P , Brookfield WI 53045-2931. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Johnson, Mary Susan can be contacted via phone (262) 879-0010.

Contact Information

Primary practice address
18000 W Bluemound Rd Ste P Brookfield WI 53045-2931
Phone: (262) 879-0010
Fax: (262) 879-9781
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 3796 Wisconsin

Profile Details

NPI number 1861589723
LBN Legal business name Johnson, Mary Susan
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Dec 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861589723 NPPES
Wisconsin Other 2002030008 ANTHEM BCBS PROVIDER NUMBER
Wisconsin Other 3796-024 ANTHEM BCBS PROVIDER NUMBER
Wisconsin Other 83388002 ANTHEM BCBS PROVIDER NUMBER

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