Individual
DANIEL THOMAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-4887
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12638
MN
Other
Enumeration date
03/07/2018
Last updated
05/03/2024
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