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General NPI Number Information
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NPI Number | 1619221082
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Entity Type | Organization
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Legal Business Name | JOHNSON CHIROPRACTIC CENTER, PC
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 201 N. COLLEGIATE #900
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City | PARIS
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State | TX
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Zip | 75460
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Country | US
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Telephone | 903-905-4939
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Fax | 903-905-4940
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Provider Business Mailing Address
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Address Line | 201 N. COLLEGIATE #900
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City | PARIS
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State | TX
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Zip | 75460
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Country | US
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Telephone | 903-905-4939
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Fax | 903-905-4940
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Authorized Official
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Title or Position | PRESIDENT/DOCTOR
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Name | DR. STEPHEN CLARK JOHNSON
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Credential | D.C.
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Telephone | 903-905-4939
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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 | 10808
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License Number State | TX
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