Individual
GARY E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3902 13TH AVE S STE 406, FARGO, ND 58103-3357
(701) 277-9555
Mailing address
5092 MARION ST S, FARGO, ND 58104-6050
(701) 640-8773
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
607
ND
Other
Enumeration date
07/18/2006
Last updated
08/28/2019
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