Provider Demographics
NPI:1841475993
Name:JOHNSON, LANA (DC)
Entity type:Individual
Prefix:DR
First Name:LANA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LANA
Other - Middle Name:
Other - Last Name:NOFZIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:301 STRYKER ST
Mailing Address - Street 2:NUMBER B
Mailing Address - City:ARCHBOLD
Mailing Address - State:OH
Mailing Address - Zip Code:43502-1144
Mailing Address - Country:US
Mailing Address - Phone:567-444-4574
Mailing Address - Fax:
Practice Address - Street 1:301 STRYKER ST
Practice Address - Street 2:NUMBER B
Practice Address - City:ARCHBOLD
Practice Address - State:OH
Practice Address - Zip Code:43502-1144
Practice Address - Country:US
Practice Address - Phone:567-444-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor