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Individual

AMY JOHANEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734
(320) 250-7703
Mailing address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2248
MN

Other

Enumeration date
05/17/2011
Last updated
02/29/2012
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