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General NPI Number Information
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NPI Number | 1780238766
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Entity Type | Individual
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Provider Name | GARTH JOHNSON DC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 210 LAFAYETTE ST
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City | PITTSBURG
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State | TX
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Zip | 75686-1630
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Country | US
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Telephone | 903-856-3665
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Fax |
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Provider Business Mailing Address
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Address Line | DBA CAMP COUNTY CLINIC OF CHIROPRACTIC & REHAB 210 LAFAYETTE ST
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City | PITTSBURG
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State | TX
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Zip | 75686-1630
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Country | US
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Telephone | 903-856-3665
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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 | 14179
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License Number State | TX
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