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1811964174
BLAKE A JOHNSON
ST LOUIS PARK, MN
NPI
1811964174
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: MN 39490)
Enumeration Date
2006-03-07
Last Update Date
2012-02-17
Business Address
-- BLAKE A JOHNSON MD
5775 WAYZATA BLVD STE 190
ST LOUIS PARK, MN 55416
Phone number: 952-541-1840
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Mailing Address
-- BLAKE A JOHNSON MD
PO BOX 1450 NW6035
MINNEAPOLIS, MN 55485-6035
Phone number: 952-542-8553
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