Individual
BO JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 MONMOUTH AVE N, MONMOUTH, OR 97361-1329
(503) 838-8343
Mailing address
427 KESTREL ST N, KEIZER, OR 97303-5311
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
About Stedi
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