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1982074696
BRETT JOHANSEN
FRUITLAND, ID
NPI
1982074696
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-1308)
Enumeration Date
2015-10-07
Last Update Date
2015-10-07
Business Address
-- BRETT JOHANSEN PA-C
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-9881
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Mailing Address
-- BRETT JOHANSEN PA-C
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-9881
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