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NPI Code Detail

MEDICARE: DR. KEVIN STUART JOHNSON DC

MEDICARE: DR. KEVIN STUART JOHNSON DC
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
1111N00000XChiropractor27 2166OR

General Provider Information

NPI Number : 1194867200
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN STUART JOHNSON DC
Provider Business Mailing Address
First Line : 229 N EGAN AVE
Second Line :
City : BURNS
State : OR
Zip : 97720-1741
Country : US
Telephone Number : 541-573-7733
Fax Number : 541-573-7732
Provider Business Practice Location Address
First Line : 229 N EGAN AVE
Second Line :
City : BURNS
State : OR
Zip : 97720-1741
Country : US
Telephone Number : 541-573-7733
Fax Number : 541-573-7732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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Directions to “ DR. KEVIN STUART JOHNSON DC” Practice Location

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