Provider Demographics
NPI:1700379930
Name:DAVIS, JOHNNY JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:
Last Name:DAVIS
Suffix:JR
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 1:200 W COUNTY LINE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2342
Mailing Address - Country:US
Mailing Address - Phone:303-913-4737
Mailing Address - Fax:303-975-6950
Practice Address - Street 1:200 W COUNTY LINE RD STE 310
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2342
Practice Address - Country:US
Practice Address - Phone:303-913-4737
Practice Address - Fax:303-975-6950
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor