Individual
KEVIN NEIL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT,ATC
Contact information
Practice address
9913 214TH ST W STE B, LAKEVILLE, MN 55044-1914
(952) 985-2020
Mailing address
9913 214TH ST W STE B, LAKEVILLE, MN 55044-1914
(952) 985-2020
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4901
MN
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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