Benjamin Nord Johnson, CMT

Individual provider Active NPI Massage Therapist · Albertville, MN

NPI 1871260232 · NPPES record last updated Aug 24, 2021

Key facts

NPI
1871260232
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
Practice address
10904 57TH St NE
Albertville, MN 55301-4658
Phone
(612) 512-9305
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225700000X Yes

Addresses

Primary practice location

10904 57TH St NE
Albertville, MN 55301-4658

Mailing address

3678 Brentwood Dr
Monticello, MN 55362-8730
Phone (612) 512-9305

Other providers in Albertville, MN

All providers in Albertville, MN · Massage Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.