Individual
THOR JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 6TH ST W, PARK RAPIDS, MN 56470-1301
(218) 244-0595
Mailing address
102 W RIVER ST, BIGFORK, MN 56628-4320
(218) 244-0595
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2552
MN
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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