Individual
KEALY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13876 KELLY DR, BAXTER, MN 56425-7422
(218) 821-5651
Mailing address
13876 KELLY DR, BAXTER, MN 56425-7422
(218) 821-5651
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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