Individual
KENT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3301 HIGHWAY 10 E, T0658, MOORHEAD, MN 56560-2516
(218) 233-2953
(218) 233-2953
Mailing address
3301 HIGHWAY 10 E, T0658, MOORHEAD, MN 56560-2516
(218) 233-2953
(218) 233-2953
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
112738
MN
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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