Individual
ANNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
11725 STINSON AVE, CHISAGO CITY, MN 55013-9542
(651) 257-8469
Mailing address
730 10TH ST NW APT 7, NEW BRIGHTON, MN 55112-6724
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1864
MN
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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