Individual
STEVEN OLOF JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
106 SOUTH MAIN STREET, UPSALA, MN 56384-0363
(320) 573-2071
Mailing address
PO BOX 363, UPSALA, MN 56384-0363
(320) 573-2071
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1601
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC366JO
BLUE CROSS BLUEE SHIELD
MN
Enumeration date
12/21/2006
Last updated
07/08/2007
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