Individual
DR. MARK ROBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2780 SNELLING AVE N, SUITE 301, ROSEVILLE, MN 55113-7115
(651) 633-9667
(651) 633-4203
Mailing address
408 4TH AVE NE, OSSEO, MN 55369-1122
(763) 425-2347
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2010
MN
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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