Individual
BETTY LOU JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
11 CENTRAL AVE S, ELBOW LAKE, MN 56531-4101
(218) 685-4471
(218) 685-5209
Mailing address
18050 270TH ST, ELBOW LAKE, MN 56531-9103
(218) 685-5193
(218) 685-5209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
113477-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113477-1
PHARMACIST LICENSE
MN
Enumeration date
08/10/2005
Last updated
07/08/2007
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