Dayton Nels Johnson, DPT | |
10 5th St Se, Cook, MN 55723-9702 | |
(218) 666-5945 | |
Not Available |
Full Name | Dayton Nels Johnson |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 10 5th St Se, Cook, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013571751 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Merion Square Road Medical Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1942923123 PECOS PAC ID: 0446605422 Enrollment ID: O20240104003037 |
Mailing Address | Practice Location Address |
---|---|
Dayton Nels Johnson, DPT 1491 Old Highway 19, Red Wing, MN 55066-1136 Ph: (651) 764-8130 | Dayton Nels Johnson, DPT 10 5th St Se, Cook, MN 55723-9702 Ph: (218) 666-5945 |
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