Provider Demographics
NPI:1689122632
Name:JOHNSON, CHRISTOPHER NEAL (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NEAL
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 1:15 STORY ST
Mailing Address - Street 2:BASEMENT LEVEL
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4950
Mailing Address - Country:US
Mailing Address - Phone:617-441-0101
Mailing Address - Fax:617-441-0100
Practice Address - Street 1:15 STORY ST
Practice Address - Street 2:BASEMENT LEVEL
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4950
Practice Address - Country:US
Practice Address - Phone:617-441-0101
Practice Address - Fax:617-441-0100
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor