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Individual

BRYAN DOUGLAS JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2501 RICE LAKE RD, DULUTH, MN 55811-4819
(864) 513-6864
Mailing address
PO BOX 4, ESKO, MN 55733-0004

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11824
MN

Other

Enumeration date
06/12/2020
Last updated
06/12/2020
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