MEDICARE: DR. ADAM D JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	MC 05834	NJ

General Provider Information

NPI Number	:	1366639528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM D JOHNSON

Provider Business Mailing Address
First Line	:	PO BOX 160
Second Line	:
City	:	JAMESBURG
State	:	NJ
Zip	:	08831-0160
Country	:	US
Telephone Number	:	732-521-0679
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 FORSGATE DR
Second Line	:
City	:	MONROE TWP
State	:	NJ
Zip	:	08831-1539
Country	:	US
Telephone Number	:	732-521-0679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	10/01/2007

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