MEDICARE: DR. ALBERT T 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	DCB417	NV

General Provider Information

NPI Number	:	1801905526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT T JOHNSON D.C.

Provider Business Mailing Address
First Line	:	4600 KIETZKE LN
Second Line	:	SUITE N258
City	:	RENO
State	:	NV
Zip	:	89502-5033
Country	:	US
Telephone Number	:	775-826-2200
Fax Number	:	775-826-2492

Provider Business Practice Location Address
First Line	:	4600 KIETZKE LN
Second Line	:	SUITE N258
City	:	RENO
State	:	NV
Zip	:	89502-5033
Country	:	US
Telephone Number	:	775-826-2200
Fax Number	:	775-826-2492

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	11/28/2007

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