Individual
BRIAN R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3201 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-5402
(651) 770-0311
Mailing address
3201 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-5402
(651) 770-0311
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112050
MN
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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