Organization
JOHNSON CHIROPRACTIC CLINIC
Active
Other names
Johnson Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA MARIE JOHNSON-STEVENSON BS DC CCEP (PRESIDENT)
(208) 324-3730
Entity
Organization
Contact information
Practice address
600 N LINCOLN AVE, JEROME, ID 83338
(208) 324-3730
(208) 324-5512
Mailing address
600 N LINCOLN AVE, JEROME, ID 83338
(208) 324-3730
(208) 324-5512
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO 584
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10019692
BLUE SHIELD OF IDAHO
ID
01
—
8N046
BLUE CROSS OF IDAHO
ID
Enumeration date
10/11/2006
Last updated
10/22/2012
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