Individual
DR. STACY MAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
118 E 4TH ST, ZUMBROTA, MN 55992-1520
(507) 732-7455
(507) 732-7455
Mailing address
118 E 4TH ST, ZUMBROTA, MN 55992-1520
(507) 732-7455
(507) 732-7455
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
003569
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6C412FA
BLUE CROSS BLUE SHIELD OF
MN
Enumeration date
09/22/2006
Last updated
07/08/2007
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