Individual
BRENDA GARRETT-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4862
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017N3PH
BCBS OF MN
MN
05
—
048192000
—
MN
01
—
6405396
MEDICA-UNITED HEALTHCARE
MN
Enumeration date
07/30/2006
Last updated
05/26/2010
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