Healthcare Provider Details

I. General information

NPI: 1730001389
Provider Name (Legal Business Name): KATHRYN JOHNSON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE JOHNSON DC

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 FRAIRY ST
MEDFIELD MA
02052-1609
US

IV. Provider business mailing address

29 FRAIRY ST
MEDFIELD MA
02052-1609
US

V. Phone/Fax

Practice location:
  • Phone: 978-417-9210
  • Fax:
Mailing address:
  • Phone: 978-417-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5332
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHI5258
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: