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1376136481
BRENT LEE JOHNSON
EDINA, MN
NPI
1376136481
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 12100)
Enumeration Date
2021-02-19
Last Update Date
2021-02-19
Business Address
BRENT LEE JOHNSON
6401 FRANCE AVE S
EDINA, MN 55435-2199
Phone number: 952-924-5000
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Mailing Address
BRENT LEE JOHNSON
13243 BITTERSWEET ST NW
COON RAPIDS, MN 55448-1214
Phone number:
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