Individual
BENJAMIN BRADLEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6233 BANKERS RD STE 12, MT PLEASANT, WI 53403-9700
(262) 771-0404
(844) 605-3317
Mailing address
352A E ROSEDALE AVE, MILWAUKEE, WI 53207-2068
(920) 287-9966
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15022-24
WI
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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