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Individual

RANDY LEE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
824 9TH ST N, SARTELL, MN 56377-2248
(320) 290-9506
(866) 392-7760
Mailing address
824 9TH ST N, P.O.BOX 186, SARTELL, MN 56377-2248
(320) 290-9506
(866) 392-7760

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary

Other

Enumeration date
06/22/2011
Last updated
06/22/2011
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