MEDICARE: GARTH 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
1	111N00000X	Chiropractor	14179	TX

General Provider Information

NPI Number	:	1780238766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARTH JOHNSON DC

Provider Business Mailing Address
First Line	:	DBA CAMP COUNTY CLINIC OF CHIROPRACTIC & REHAB
Second Line	:	210 LAFAYETTE ST
City	:	PITTSBURG
State	:	TX
Zip	:	75686-1630
Country	:	US
Telephone Number	:	903-856-3665
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 LAFAYETTE ST
Second Line	:
City	:	PITTSBURG
State	:	TX
Zip	:	75686-1630
Country	:	US
Telephone Number	:	903-856-3665
Fax Number	:

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

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	09/25/2019

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Directions to “ GARTH JOHNSON DC” Practice Location

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