Individual
HEIDI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
108 PANTHER LN, MANKATO, MN 56001-8649
(651) 303-6797
Mailing address
108 PANTHER LN, MANKATO, MN 56001-8649
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121289
MN
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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