BRETT JOHANSEN

FRUITLAND, ID
NPI1982074696
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA-1308)
Enumeration Date2015-10-07
Last Update Date2015-10-07
Business Address
-- BRETT JOHANSEN PA-C
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-9881
Mailing Address
-- BRETT JOHANSEN PA-C
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-9881
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