Provider Demographics
NPI:1710054341
Name:JOHNSTON, JOSEPH L (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
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 1:1230 SEMINOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3523
Mailing Address - Country:US
Mailing Address - Phone:407-695-0400
Mailing Address - Fax:407-695-0083
Practice Address - Street 1:1230 SEMINOLA BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3523
Practice Address - Country:US
Practice Address - Phone:407-695-0400
Practice Address - Fax:407-695-0083
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88019Medicare ID - Type UnspecifiedCHIROPRACTIC