Individual
MR. MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
418 OPAL LN, HIBBING, MN 55746-3844
(218) 263-6205
Mailing address
418 OPAL LN, HIBBING, MN 55746-3844
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111573
MN
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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