Brent M Johnson PA

NPI 1093715013 - Physician Assistant - 363A00000X

NPI Details
NPI 1093715013
Gender Male
Enumeration Date 08/01/2005
Last Updated 06/07/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
300 S RATH AVE
STE. 102
LUDINGTON MI, 49431-3003, US
Phone (231) 843-2543
Fax (231) 843-2547
Business Location
300 S RATH AVE
STE. 102
LUDINGTON MI, 49431-3003, US
Phone (231) 843-2543
Fax (231) 843-2547
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601003020
Remove 1093715013 NPI Number
 

According to our database, Brent M Johnson PA NPI is 1093715013, taxonomy code is 363A00000X and license number is 5601003020, license state is located at Michigan. Brent M Johnson PA physically located at 300 S Rath Ave, Ludington MI, 49431-3003. NPI Number Brent M Johnson PA has the Individual type.

Sponsored links

1093715013 NPI number is provided on an as is basis without warranty of any kind. 1093715013 is maintained by the National Plan & Provider Enumeration System. The contents of Brent M Johnson PA are for informational purposes only.