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Organization
KIMBERLEY M JOHNSON DC
Active
Organization
KIMBERLEY M JOHNSON DC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLEY M JOHNSON DC (CHIROPRACTOR OWNER)
(651) 257-3900
Entity
Organization
Contact information
Practice address
12814 LAKE BOULEVARD, LINDSTROM, MN 55045
(651) 257-3900
(651) 257-3932
Mailing address
PO BOX 567, 12814 LAKE BLVD, LINDSTROM, MN 55045-0567
(651) 257-3900
(651) 257-3932
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3423
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02B15LA PIN 02B16J0
BCBS
—
01
—
183022800
MA
—
Enumeration date
11/17/2006
Last updated
10/29/2007
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