Provider Demographics
NPI:1073781332
Name:ALTERNATIVE HEALTH CENTERS PC
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH CENTERS PC
Other - Org Name:JOHNSON CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-882-0100
Mailing Address - Street 1:611 6TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-4938
Mailing Address - Country:US
Mailing Address - Phone:605-882-0100
Mailing Address - Fax:605-882-6911
Practice Address - Street 1:611 6TH ST SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-4938
Practice Address - Country:US
Practice Address - Phone:605-882-0100
Practice Address - Fax:605-882-6911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE HEALTH CENTERS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-20
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD845261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD41523Medicare PIN