Individual
BETHANEY COLETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5695 DULUTH ST, GOLDEN VALLEY, MN 55422-4054
(763) 546-5336
Mailing address
12349 5TH ST NE, BLAINE, MN 55434-2644
(720) 252-7020
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123361
MN
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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