MEDICARE: JOHNSON CHIROPRACTIC CENTER PLLC

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	2301005521	MI

General Provider Information

NPI Number	:	1669536355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON CHIROPRACTIC CENTER PLLC

Provider Business Mailing Address
First Line	:	6985 MERRIMAN RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-1960
Country	:	US
Telephone Number	:	734-466-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6985 MERRIMAN RD
Second Line	:
City	:	GARDEN CITY
State	:	MI
Zip	:	48135-1960
Country	:	US
Telephone Number	:	734-466-3500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD BRIAN JOHNSON
Credential	:	DC
Telephone Number	:	734-466-3500

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	08/22/2020

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