=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588463327
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NASH WILLIAM JOHNSTON DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2025
-----------------------------------------------------
Last Update Date | 03/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 910 N 8TH ST W
-----------------------------------------------------
City | RIVERTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82501-2332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-463-2770
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 703 SPENCER ST APT 1
-----------------------------------------------------
City | RIVERTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82501-2765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-492-3404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 868
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------