SHANE JOHANNSEN

SAINT PAUL, MN
NPI1750171997
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2025-05-10
Last Update Date2025-05-10
Business Address
SHANE JOHANNSEN MD
640 JACKSON ST
SAINT PAUL, MN 55101-2595
Phone number: 651-254-5091
Mailing Address
SHANE JOHANNSEN MD
640 JACKSON ST
SAINT PAUL, MN 55101-2595
Phone number: 651-254-5091