Individual
MR. THOMAS MARK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
N5733 GURHOLT LAKE RD, SCANDINAVIA, WI 54977-9736
(715) 467-2324
Mailing address
N5733 GURHOLT LAKE RD, SCANDINAVIA, WI 54977-9736
(715) 467-2324
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
69342-30
WI
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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