Provider Demographics
NPI:1124865803
Name:BORIO JOHNSON CHIROPRACTIC HEALTH CENTER PC
Entity type:Organization
Organization Name:BORIO JOHNSON CHIROPRACTIC HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-304-8666
Mailing Address - Street 1:1429 PRAIRIE PKWY SW UNIT 410
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-2893
Mailing Address - Country:US
Mailing Address - Phone:616-304-8666
Mailing Address - Fax:
Practice Address - Street 1:8212 BREWERTON RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-6403
Practice Address - Country:US
Practice Address - Phone:616-304-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty