Individual
WADE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
63980
MN
Other
Enumeration date
09/14/2014
Last updated
10/27/2020
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