Individual
DR. TIMOTHY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
195 EAST 14TH ST., FOND DU LAC, WI 54936-1451
(920) 921-4910
Mailing address
195 EAST 14TH ST., FOND DU LAC, WI 54936-1451
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1431-012
WI
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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