Provider Demographics
NPI:1114206711
Name:C JOHNSON ENTERPRISES LLC
Entity Type:Organization
Organization Name:C JOHNSON ENTERPRISES LLC
Other - Org Name:CHIROPRACTIC ACUPUNCTURE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-408-5600
Mailing Address - Street 1:405 OLD BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2658
Mailing Address - Country:US
Mailing Address - Phone:205-408-5600
Mailing Address - Fax:205-408-0797
Practice Address - Street 1:2800 GREYSTONE COMMERCIAL BLVD
Practice Address - Street 2:STE 2B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2667
Practice Address - Country:US
Practice Address - Phone:205-408-5600
Practice Address - Fax:205-408-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU89938Medicare UPIN