=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740372614
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHERIE R JOHNSON DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 11/28/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2800 GREYSTONE COMMERCIAL BLVD STE 2B
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-2667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-408-5600
-----------------------------------------------------
Fax | 205-408-0797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2800 GREYSTONE COMMERCIAL BLVD STE 2B
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35242-2667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-408-5600
-----------------------------------------------------
Fax | 205-408-0797
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2030
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1023
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------