Individual
STEPHEN TIMOTHY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10700 OLD COUNTY ROAD 15, SUITE 240, PLYMOUTH, MN 55441
(763) 544-2001
Mailing address
10700 OLD COUNTY ROAD 15, SUITE 240, PLYMOUTH, MN 55441
(763) 544-2001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
03050
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4C840JO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/11/2006
Last updated
07/08/2007
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