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1366934440
BENJAMIN HENNING JOHNSON
MOSCOW, ID
NPI
1366934440
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-06-04
Last Update Date
2018-06-04
Business Address
BENJAMIN HENNING JOHNSON
875 PERIMETER DR # MS 2401
MOSCOW, ID 83844-9803
Phone number: 801-710-0760
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Mailing Address
BENJAMIN HENNING JOHNSON
5345 S 4550 W
HOOPER, UT 84315-6710
Phone number:
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