MEDICARE: DR. KORY 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	2014015304	MO
2	111N00000X	Chiropractor	1352	HI
3	111N00000X	Chiropractor	CH12344	FL

General Provider Information

NPI Number	:	1720490865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KORY JOHNSON D.C.

Provider Business Mailing Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	417-234-7861
Fax Number	:

Provider Business Practice Location Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	417-234-7861
Fax Number	:

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

Provider Enumeration Date	:	05/23/2014
Last Update Date	:	07/08/2025

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