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General NPI Number Information
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NPI Number | 1417285917
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Entity Type | Organization
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Legal Business Name | LU ELAINE JOHNSON CHIROPRACTOR, INC.
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 99228 OVERSEAS HIGHWAY
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City | KEY LARGO
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State | FL
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Zip | 33037-7732
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Country | US
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Telephone | 305-453-3337
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Fax | 305-453-3337
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Provider Business Mailing Address
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Address Line | 99228 OVERSEAS HWY
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City | KEY LARGO
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State | FL
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Zip | 33037-2468
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Country | US
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Telephone | 305-453-3337
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Fax | 305-453-3337
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Authorized Official
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Title or Position | PRESIDENT
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Name | LU ELAINE JOHNSON
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Credential | DC
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Telephone | 305-453-3337
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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 | CH8222
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License Number State | FL
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