Provider Demographics
NPI:1881085553
Name:JOHNSON, ERIK (LAC, BD, DNM)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LAC, BD, DNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13701 W JEWELL AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4173
Mailing Address - Country:US
Mailing Address - Phone:303-500-5075
Mailing Address - Fax:
Practice Address - Street 1:13701 W JEWELL AVE STE 204
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4173
Practice Address - Country:US
Practice Address - Phone:303-500-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002191171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist