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Individual

MARISE K JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1280 BURNS WAY, KALISPELL, MT 59901-3110
(406) 755-5266
(406) 755-0228
Mailing address
1280 BURNS WAY, KALISPELL, MT 59901-3110
(406) 755-5266
(406) 755-0228

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
4632
MT
207R00000X
Internal Medicine Physician
Primary
4632
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0011687
MT
Enumeration date
06/08/2006
Last updated
11/27/2023
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