Organization
ORTHOTIC AND PROSTHETIC HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E JOHANSEN CO (PRESIDENT)
(605) 886-3272
Entity
Organization
Contact information
Practice address
810 S MAPLE, WATERTOWN, SD 57201-4859
(605) 886-3272
(218) 847-7676
Mailing address
810 S MAPLE, WATERTOWN, SD 57201-4859
(605) 886-3272
(218) 847-7676
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9162720
—
SD
Enumeration date
01/12/2007
Last updated
07/21/2022
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