Brett Johansen, PA-C

NPI #1982074696 in Fruitland, Idaho

Provider Information

NPI Number
1982074696
Entity Type
Individual
Name
Brett Johansen, PA-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Medical
Credential
PA-C
Enumeration Date
Oct 7, 2015
Last Updated
Oct 7, 2015

Practice Location

Address
1210 NW 16TH ST
State
Idaho
ZIP Code
83619-2202
Phone
(208) 452-9881

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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