Individual
MR. MITCHELL STEVEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
350 CONSTANCE BLVD, WILLIAMS BAY, WI 53191-9547
(262) 245-5531
Mailing address
1303 SCOTTSWOOD RD, ROCKFORD, IL 61107-2063
(815) 378-4999
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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