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General NPI Number Information
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NPI Number | 1063500866
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Entity Type | Individual
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Provider Name | WILLIAM GEORGE JOHNSON DC
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 502 N ELIDA ST
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City | WINNEBAGO
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State | IL
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Zip | 61088-8946
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Country | US
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Telephone | 815-335-2820
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Fax | 815-335-2009
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Provider Business Mailing Address
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Address Line | PO BOX 413
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City | WINNEBAGO
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State | IL
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Zip | 61088-0413
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Country | US
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Telephone | 815-335-2820
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Fax | 815-335-2009
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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