MEDICARE: DR. DAVID J JOHNSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH0002201	FL

General Provider Information

NPI Number	:	1063449163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID J JOHNSON D.C.

Provider Business Mailing Address
First Line	:	7322 SUNSHINE CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-2253
Country	:	US
Telephone Number	:	813-884-6330
Fax Number	:	813-884-5520

Provider Business Practice Location Address
First Line	:	5511 HANLEY RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-4903
Country	:	US
Telephone Number	:	813-885-7580
Fax Number	:	813-884-5520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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