Individual
DR. MICHAEL JEROME JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
700 9TH AVE S, WATERTOWN, SD 57201
(605) 882-9424
Mailing address
1511 HILLCREST DR N, WATERTOWN, SD 57201-5747
(605) 886-6696
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2428
MN
152W00000X
Optometrist
Primary
503
SD
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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