William Johnson

NPI 1043504889 · on the registry since 2011 · sole proprietor

Practice

Address: 755 53rd Ave Ne
Fridley, MN 55421
Phone: (763) 571-9766
Fax: (763) 852-0086
Organisation at this address: Fridley Target Clinic
Grand St Paul Cvs Llc
Luxottica Of America Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: 183500000X
183500000X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-06-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota