Travis M. Johnson O.D.

NPI 1003890609 - Optometrist - 152W00000X

NPI Details
NPI 1003890609
Gender Male
Enumeration Date 12/06/2005
Last Updated 10/20/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
13481 60TH ST N
SUITE 200
STILLWATER MN, 55082-1055, US
Phone (651) 439-6400
Fax (651) 439-6405
Business Location
247 PLUM TREE LN
SOMERSET WI, 54025-7578, US
Phone (651) 230-3554
Fax (651) 439-6405
Toxanomy
Taxonomy Code 152W00000X
License State Minnesota
License Number 2763
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According to our database, Dr. Travis M. Johnson O.D. NPI is 1003890609, taxonomy code is 152W00000X and license number is 2763, license state is located at Minnesota. Travis M. Johnson O.D. physically located at 13481 60th St N, Stillwater MN, 55082-1055. NPI Number Travis M. Johnson O.D. has the Individual type.

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1003890609 NPI number is provided on an as is basis without warranty of any kind. 1003890609 is maintained by the National Plan & Provider Enumeration System. The contents of Travis M. Johnson O.D. are for informational purposes only.