Individual
JERILYN ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1284 CORPORATE CENTER DR, SUITE 500, EAGAN, MN 55121-1253
(651) 686-0098
(651) 686-0499
Mailing address
4416 43RD AVE S, MINNEAPOLIS, MN 55406-4051
(612) 722-4329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6285
MN
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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