NICHOLAS BRADFORD JOHNSON

IDAHO FALLS, ID
NPI1578850210
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: ID  M-14721)
Additional Taxonomies208200000X Plastic Surgery
(Licence: ID  M-14721)
208200000X Plastic Surgery
(Licence: GA  83999)
208200000X Plastic Surgery
(Licence: IN  01076429A)
Enumeration Date2011-07-01
Last Update Date2024-02-28
Business Address
NICHOLAS BRADFORD JOHNSON
3200 CHANNING WAY STE 206
IDAHO FALLS, ID 83404-7546
Phone number: 208-529-2230
Mailing Address
NICHOLAS BRADFORD JOHNSON
PO BOX 277381
ATLANTA, GA 30384-7381
Phone number: 208-529-2230