Individual
DR. SHANNON MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2021 ASHLAND RD, GREENUP, KY 41144-1323
(606) 473-5151
(606) 473-0163
Mailing address
2021 ASHLAND RD, GREENUP, KY 41144-1323
(606) 473-5151
(606) 473-0163
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4191
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350043083
MEDICARE RR
KY
05
—
85001295
—
KY
Enumeration date
07/27/2006
Last updated
02/10/2015
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