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Organization
BACK ON YOUR FEET CHIROPRACTIC, PA
Active
Organization
BACK ON YOUR FEET CHIROPRACTIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY R JOHNSON D.C. (PRESIDENT)
(612) 638-7339
Entity
Organization
Contact information
Practice address
1115 VICKSBURG LN N, STE 11, PLYMOUTH, MN 55447-3215
(612) 638-7339
Mailing address
921 BAXTER AVE N, GLENCOE, MN 55336-2723
(320) 864-3817
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881468600
—
MN
Enumeration date
10/20/2010
Last updated
10/20/2010
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