Individual
DR. MIKSCHAL JOHANISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
120 W CHURCH ST, FREDERICK, MD 21701-7800
(301) 642-1759
Mailing address
242 S CARROLL ST, FREDERICK, MD 21701-6523
(301) 642-1759
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U01729
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U01729
MARYLAND DEPARTMENT OF HEALTH
MD
Enumeration date
01/02/2020
Last updated
01/02/2020
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