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Individual

MISS AMANDA KAY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSA

Contact information

Practice address
201 W CENTER ST EI-01 SURGICAL ASSISTANT, ROCHESTER, MN 55902-3003
(507) 266-2827
(507) 266-1978
Mailing address
114 W. MAIN ST., PO BOX 54, DODGE CENTER, MN 55927
(507) 374-2335

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
01/22/2010
Last updated
01/22/2010
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