Provider Demographics
NPI:1255367298
Name:JOHNSTONE, JESSICA (DC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:JOHNSTONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-4744
Mailing Address - Country:US
Mailing Address - Phone:563-940-5852
Mailing Address - Fax:
Practice Address - Street 1:506 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-4744
Practice Address - Country:US
Practice Address - Phone:563-324-8888
Practice Address - Fax:563-324-8888
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor