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General NPI Number Information
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NPI Number | 1376194662
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Entity Type | Individual
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Provider Name | KELLY MARIE MCGEE JOHNSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 3544 CLARK RD
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City | SARASOTA
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State | FL
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Zip | 34231-8408
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Country | US
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Telephone | 941-404-1253
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Fax |
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Provider Business Mailing Address
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Address Line | 308 CANTABRIA TRL
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City | BRADENTON
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State | FL
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Zip | 34208-1586
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Country | US
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Telephone | 740-243-9923
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Fax |
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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 | 04922
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License Number State | OH
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