Individual
KEVIN LYNCH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 JACOB LN, ANOKA, MN 55303-1776
(763) 587-4400
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14262
MN
Other
Enumeration date
09/14/2019
Last updated
02/03/2023
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