Provider Demographics
NPI:1144398090
Name:JOHNS, ROBERT O (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:O
Last Name:JOHNS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6352 SE WILDLIFE ESTATE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267
Mailing Address - Country:US
Mailing Address - Phone:503-655-3259
Mailing Address - Fax:503-659-7471
Practice Address - Street 1:619 HIGH ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2240
Practice Address - Country:US
Practice Address - Phone:503-656-4993
Practice Address - Fax:503-657-0411
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor