Individual
TERRY A JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 679-1313
(320) 225-3141
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30944
MN
Other
Enumeration date
04/12/2006
Last updated
07/08/2007
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