Provider Demographics
NPI:1972009322
Name:JOHNSON, DEVIN D (DC)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:D
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 1:8300 OLD CHENEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3540
Mailing Address - Country:US
Mailing Address - Phone:402-483-4646
Mailing Address - Fax:402-483-4649
Practice Address - Street 1:8300 OLD CHENEY RD STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3540
Practice Address - Country:US
Practice Address - Phone:402-483-4646
Practice Address - Fax:402-483-4649
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor