Individual
KENNETH DEWAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D., L.N.
Contact information
Practice address
2501 W 22ND ST, SIOUX FALLS, SD 57105-1305
(605) 336-3230
Mailing address
812 S LAKE AVE, SIOUX FALLS, SD 57104-4645
(605) 338-2009
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0003
SD
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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