Provider Demographics
NPI:1376221275
Name:JOHNSON, BRANDAN (ND, PHD)
Entity Type:Individual
Prefix:DR
First Name:BRANDAN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:ND, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1701
Mailing Address - Country:US
Mailing Address - Phone:330-941-0608
Mailing Address - Fax:
Practice Address - Street 1:345 CARROLL ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1701
Practice Address - Country:US
Practice Address - Phone:330-941-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder