Provider Demographics
NPI:1932123718
Name:JOHNSON, CHRISTOPHER PAGE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAGE
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 1:4412 FALLS OF NEUSE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6230
Mailing Address - Country:US
Mailing Address - Phone:919-876-2212
Mailing Address - Fax:919-878-3366
Practice Address - Street 1:4412 FALLS OF NEUSE RD STE 111
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6230
Practice Address - Country:US
Practice Address - Phone:919-876-2212
Practice Address - Fax:919-878-3366
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08540OtherBLUE CROSS BLUE SHIELD
NC244514Medicare ID - Type Unspecified
NCT64528Medicare UPIN