Individual
DREW AUGUST JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8836 N HESS ST, SUITE C, HAYDEN, ID 83835-8718
(208) 762-7760
(208) 762-7740
Mailing address
8836 N HESS ST, SUITE C, HAYDEN, ID 83835-8718
(208) 762-7760
(208) 762-7740
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1167
ID
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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