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Individual

CRAIG MATTHEW JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8103 UPPER 129TH CT, APPLE VALLEY, MN 55124-6283
(612) 282-8286
Mailing address
8103 UPPER 129TH CT, APPLE VALLEY, MN 55124-6283
(612) 282-8286

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
BC629235
MN

Other

Enumeration date
08/10/2020
Last updated
08/10/2020
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