Johnston, Jack Thomas

Johnston, Jack Thomas is an individual health care provider with primary practice located at 2060 Centre Pointe Blvd Ste 3 , Mendota Heights MN 55120-1271. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Johnston, Jack Thomas can be contacted via phone (612) 447-2689.

Contact Information

Primary practice address
2060 Centre Pointe Blvd Ste 3 Mendota Heights MN 55120-1271
Phone: (612) 447-2689
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1003650714
LBN Legal business name Johnston, Jack Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2024
Last updated Jun 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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