Shane P Johnson, PHARMD Valid NPI

Individual provider · Pharmacist · Spring Green, WI

NPI

1306172507

Type

Individual (Type 1)

Primary specialty

Pharmacist

Specialty group

Pharmacy Service Providers

Taxonomy code

183500000X

License number

15782-040 (WI)

Sex

Male

Sole proprietor

No

Enumerated

2009-10-22

Last updated

2009-10-22