Individual
SAMANTHA JO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CD
Contact information
Practice address
2854 GREENBRIER RD, GREEN BAY, WI 54311-6528
(920) 288-8000
Mailing address
W2857 CTY RD E, CECIL, WI 54111-9446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
338229
WI
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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