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Individual

MURRAY D JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Mailing address
PO BOX 22308, 300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2724123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39595000
WI
Enumeration date
10/04/2006
Last updated
07/08/2007
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