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NPI Code Detail

MEDICARE: DR. JENNIFER JOHNSTON D.C.

MEDICARE:  DR. JENNIFER  JOHNSTON  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
1111N00000XChiropractor2005001866MO

General Provider Information

NPI Number : 1679652911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER JOHNSTON D.C.
Provider Business Mailing Address
First Line : 3440 ILLINOIS CT
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6472
Country : US
Telephone Number : 314-540-2404
Fax Number :
Provider Business Practice Location Address
First Line : 6034 YOUNG DR
Second Line :
City : WELDON SPRING
State : MO
Zip : 63304-9103
Country : US
Telephone Number : 636-329-8774
Fax Number : 636-329-8977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JENNIFER JOHNSTON D.C.” Practice Location

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