Individual
MISS MIRIAH J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1625 RADIO DR, SUITE 220, WOODBURY, MN 55125-9407
(651) 241-3627
Mailing address
417 ROELLER AVE, WEST SAINT PAUL, MN 55118-1653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7766
MN
Other
Enumeration date
03/01/2007
Last updated
12/05/2008
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