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General NPI Number Information
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NPI Number | 1851570923
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Entity Type | Organization
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Legal Business Name | MARK JOHNSON CHIROPRACTIC P.S.C.
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 3955 ALEXANDRIA PIKE
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City | COLD SPRING
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State | KY
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Zip | 41076-2027
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Country | US
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Telephone | 859-431-4430
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Fax | 859-431-9560
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Provider Business Mailing Address
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Address Line | 3955 ALEXANDRIA PIKE
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City | COLD SPRING
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State | KY
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Zip | 41076-2027
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Country | US
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Telephone | 859-431-4430
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Fax | 859-431-9560
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MARK ANTHONY JOHNSON
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Credential | DC
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Telephone | 859-431-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5076
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License Number State | KY
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