Provider Demographics
NPI:1215364146
Name:JOHNSON, JOSHUA E (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:E
Last Name:JOHNSON
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 1:159 AFTERNOON RAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-6598
Mailing Address - Country:US
Mailing Address - Phone:801-831-1581
Mailing Address - Fax:
Practice Address - Street 1:715 MALL RING CIR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6665
Practice Address - Country:US
Practice Address - Phone:702-990-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor