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Individual

NEIL RAYMOND JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11549 POKONEN ROAD, FLOODWOOD, MN 55736
(218) 393-1412
Mailing address
11549 POKONEN ROAD, FLOODWOOD, MN 55736
(218) 393-1412

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1082354-1-AFC
MN

Other

Enumeration date
07/04/2018
Last updated
07/04/2018
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