Provider Demographics
NPI:1407070287
Name:JOHNSON FAMILY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:JOHNSON FAMILY CHIROPRACTIC INC.
Other - Org Name:JOHNSON FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-222-9355
Mailing Address - Street 1:282 E MAIDEN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4944
Mailing Address - Country:US
Mailing Address - Phone:724-222-9355
Mailing Address - Fax:724-222-9366
Practice Address - Street 1:282 E MAIDEN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4944
Practice Address - Country:US
Practice Address - Phone:724-222-9355
Practice Address - Fax:724-222-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty