Individual
DR. RANDY ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1706 EAST TENTH STREET, GAUER CHIROPRACTIC CLINIC, GLENCOE, MN 55336
(320) 864-3196
(320) 864-3197
Mailing address
1706 EAST TENTH STREET, GAUER CHIROPRACTIC CLINIC, GLENCOE, MN 55336
(320) 864-3196
(320) 864-3197
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30701128
PRIME WEST
—
01
—
370K6J0
BCBS
MN
01
—
649104
CHIROPRACTIC CARE OF MINN
MN
01
—
869035
AMERICAS PPO
MN
Enumeration date
12/14/2006
Last updated
07/08/2007
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