Provider Demographics
NPI:1255952271
Name:JOHNSON, KASEY ANNE (DC)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:ANNE
Last Name:JOHNSON
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 1:1705 E HWY 50 STE B
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5186
Mailing Address - Country:US
Mailing Address - Phone:352-404-4309
Mailing Address - Fax:352-394-8000
Practice Address - Street 1:1705 E HWY 50 STE B
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5186
Practice Address - Country:US
Practice Address - Phone:352-394-7577
Practice Address - Fax:352-394-8000
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty