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General NPI Number Information
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NPI Number | 1336298249
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Entity Type | Organization
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Legal Business Name | JOHNSON CHIROPRACTIC GROUP, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 TOWN AND COUNTRY DR SUITE E
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City | DANVILLE
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State | CA
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Zip | 94526-3960
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Country | US
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Telephone | 925-743-8210
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Fax | 925-743-8213
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Provider Business Mailing Address
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Address Line | 115 TOWN AND COUNTRY DR SUITE E
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City | DANVILLE
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State | CA
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Zip | 94526-3960
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Country | US
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Telephone | 925-743-8210
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Fax | 925-743-8213
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY SCOTT JOHNSON
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Credential | D.C., D.A.C.N.B.
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Telephone | 925-743-8210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC24925
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License Number State | CA
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