Individual
LARS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
401 W WATER ST, DECORAH, IA 52101-0030
(563) 382-3355
Mailing address
PO BOX 30, DECORAH, IA 52101-0030
(563) 382-3355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5367
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02265
WELLMARK BCBS
IA
Enumeration date
05/28/2008
Last updated
05/28/2008
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