MEDICARE: DR. HARVEY JAMES JOHNSON D.C.

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	1373	NM

General Provider Information

NPI Number	:	1629461025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY JAMES JOHNSON D.C.

Provider Business Mailing Address
First Line	:	PO BOX 922
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-0922
Country	:	US
Telephone Number	:	505-565-0548
Fax Number	:

Provider Business Practice Location Address
First Line	:	4205 HWY 314 SW
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-9768
Country	:	US
Telephone Number	:	505-565-0548
Fax Number	:

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

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

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