Provider Demographics
NPI:1528189453
Name:JOHNSTON, JOSHUA T (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:T
Last Name:JOHNSTON
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 1:2969 DANBURY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8023
Mailing Address - Country:US
Mailing Address - Phone:303-691-0022
Mailing Address - Fax:
Practice Address - Street 1:2696 S COLORADO BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5945
Practice Address - Country:US
Practice Address - Phone:303-691-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO 4764OtherSTATE LICENSE INFORMATION
CO6698960001Medicare NSC