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Individual

DANIEL JOSEPH JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
234 COLUMBIA ST, MONDOVI, WI 54755-1104
(715) 559-7978
Mailing address
234 COLUMBIA ST, MONDOVI, WI 54755-1104
(715) 559-7978

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
16693
WI

Other

Enumeration date
11/29/2018
Last updated
11/29/2018
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