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1174512461
JOHN J JOHNSEN
OSHKOSH, WI
NPI
1174512461
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: WI 4939)
Enumeration Date
2005-10-19
Last Update Date
2007-07-08
Business Address
JOHN J JOHNSEN LAT
800 ALGOMA BLVD
OSHKOSH, WI 54901-3551
Phone number: 920-424-3225
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Mailing Address
JOHN J JOHNSEN LAT
1570 MIDWAY PL
MENASHA, WI 54952-1165
Phone number: 920-720-1784
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