Individual
MR. BRADLEY CRAIG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5907
Mailing address
PO BOX 186, GRAND RAPIDS, MI 49501-0186
(616) 364-5228
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006055
MI
Other
Enumeration date
06/16/2011
Last updated
04/29/2016
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