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1437202884
JEFFREY TODD JOHNSON
SAINT CLOUD, MN
NPI
1437202884
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 1088)
Enumeration Date
2007-01-19
Last Update Date
2007-07-08
Business Address
Mr. JEFFREY TODD JOHNSON ATC
720 4TH AVE S 214 HALENBECK HALL
SAINT CLOUD, MN 56301-4442
Phone number: 320-308-2503
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Mailing Address
Mr. JEFFREY TODD JOHNSON ATC
332 RIVERSIDE DR NE
SAINT CLOUD, MN 56304-0345
Phone number: 320-656-1453
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