Provider Demographics
NPI:1497113898
Name:JOHNSON, DANIELE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-1207
Mailing Address - Country:US
Mailing Address - Phone:517-629-5505
Mailing Address - Fax:
Practice Address - Street 1:300 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-1207
Practice Address - Country:US
Practice Address - Phone:517-629-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor