Individual
MR. SHANE P JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
208 E JEFFERSON ST, SPRING GREEN, WI 53588-8002
(608) 588-2541
Mailing address
208 E JEFFERSON ST, SPRING GREEN, WI 53588-8002
(608) 588-2541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15782-040
WI
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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