Healthcare Provider Details

I. General information

NPI: 1598765448
Provider Name (Legal Business Name): CHRISTOPHER ALAN JOHNSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2119 CLIFF RD
EAGAN MN
55122-2345
US

IV. Provider business mailing address

7 TIMBERGLADE RD
BLOOMINGTON MN
55437-2216
US

V. Phone/Fax

Practice location:
  • Phone: 612-251-8173
  • Fax:
Mailing address:
  • Phone: 612-251-8173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3907
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: