Individual
JENNIFER M JOHANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
630 E STAR CT, MONTROSE, CO 81401-6702
(970) 497-7925
(855) 855-4482
Mailing address
1550 NIAGARA RD, MONTROSE, CO 81401
(970) 497-7925
(855) 855-4482
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CDRH.0059996
CO
208600000X
Surgery Physician
OP60649442
WA
Other
Enumeration date
07/01/2011
Last updated
06/27/2024
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