Individual
MANDY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2730 PAINTBALL WAY, LINCOLN, ND 58504-2500
(701) 955-2102
(701) 955-5715
Mailing address
1000 TACOMA AVE, STE 500, BISMARCK, ND 58504-7093
(701) 751-3001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2219
ND
225100000X
Physical Therapist
5265
ID
Other
Enumeration date
11/13/2017
Last updated
03/25/2022
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