Healthcare Provider Details

I. General information

NPI: 1992967442
Provider Name (Legal Business Name): JOHNSON HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N CALUMET RD
CHESTERTON IN
46304-2426
US

IV. Provider business mailing address

114 N CALUMET RD
CHESTERTON IN
46304-2426
US

V. Phone/Fax

Practice location:
  • Phone: 219-926-3310
  • Fax: 219-926-3350
Mailing address:
  • Phone: 219-926-3310
  • Fax: 219-926-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW IVAN JOHNSON
Title or Position: OWNER
Credential: D.C.
Phone: 219-926-3310