MEDICARE: DR. LAUREN 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	CHR.0007696	CO
2	111NP0017X	Pediatric Chiropractor	CHR.0007696	CO

General Provider Information

NPI Number	:	1972074854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN JOHNSON

Provider Business Mailing Address
First Line	:	307 CHEYENNE BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-2523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 CAMPUS DR STE 230
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3177
Country	:	US
Telephone Number	:	719-627-4969
Fax Number	:

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

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	12/17/2018

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Directions to “ DR. LAUREN JOHNSON ” Practice Location

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