Individual
BENJAMIN TANKEVER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 E 18TH ST, CHEYENNE, WY 82001-5511
(307) 633-7370
(307) 637-7202
Mailing address
13001 E 17TH PL BLDG 500, AURORA, CO 80045-2570
(303) 724-6019
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16324A
WY
Other
Enumeration date
04/15/2019
Last updated
01/23/2024
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