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Organization
JOHNSTON CHIROPRACTIC CLINIC, INC.
Active
Organization
JOHNSTON CHIROPRACTIC CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R. MARC JOHNSTON D.C., Q.M.E. (CHIROPRACTOR)
(805) 541-2727
Entity
Organization
Contact information
Practice address
1150 GROVE ST, SAN LUIS OBISPO, CA 93401-2914
(805) 541-2727
(805) 541-2729
Mailing address
1150 GROVE ST, SAN LUIS OBISPO, CA 93401-2914
(805) 541-2727
(805) 541-2729
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11453
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC11453
OTHER INS. INDIVIDUAL #
CA
01
—
WDC11453A
OTHER INS. INDIVIDUAL #
CA
01
—
ZZZ86105Z
BLUE CROSS/SHIELD GROUP
CA
Enumeration date
06/25/2006
Last updated
11/07/2007
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