Provider Demographics
NPI:1295827277
Name:JOHNSON, WILLIAM F (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
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 1:393 W WARNER RD #119
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-3443
Mailing Address - Country:US
Mailing Address - Phone:480-963-4000
Mailing Address - Fax:480-786-5331
Practice Address - Street 1:393 W WARNER RD #119
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-3443
Practice Address - Country:US
Practice Address - Phone:480-963-4000
Practice Address - Fax:480-786-5331
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860679987OtherTAX IDENTIFICATION #
AZ860679987OtherTAX IDENTIFICATION #