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General NPI Number Information
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NPI Number | 1952521676
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Entity Type | Organization
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Legal Business Name | FAMILY CHIROPRACTIC PLUS PA
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 400 SELBY AVE SUITE N
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City | SAINT PAUL
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State | MN
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Zip | 55102-4508
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Country | US
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Telephone | 651-735-1088
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Fax | 651-735-2505
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Provider Business Mailing Address
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Address Line | 400 SELBY AVE SUITE N
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City | SAINT PAUL
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State | MN
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Zip | 55102-4508
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Country | US
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Telephone | 651-735-1088
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Fax | 651-735-2505
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. MICHAEL SCOTT JOHNSON
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Credential | D.C.
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Telephone | 651-735-1088
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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 | DC 3989
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License Number State | MN
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