Individual
DR. JESSY CHARLES-JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5654-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238257
—
WI
Enumeration date
05/05/2021
Last updated
01/03/2024
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