Individual
MEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 30TH AVE S, MOORHEAD, MN 56560-4926
(218) 331-2668
Mailing address
7671 CUB CREEK WAY, HORACE, ND 58047-5527
(218) 234-4108
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
125619
MN
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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