Individual
BRETT M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
61 CHARLES ST, DEADWOOD, SD 57732-1303
(605) 717-6000
Mailing address
61 CHARLES ST, DEADWOOD, SD 57732-1303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1081
SD
Other
Enumeration date
05/25/2017
Last updated
05/25/2017
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