Individual
KATHRYN MANDELBAUM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2575 SPRUCE ST, BOULDER, CO 80302-3806
(303) 449-3594
(303) 449-3112
Mailing address
345 MAXWELL AVE, BOULDER, CO 80304-3972
(303) 544-5783
(303) 441-2388
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3470
CO
Other
Enumeration date
10/26/2006
Last updated
10/08/2012
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