Organization
JOHNSON NATURAL HEALTH CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY WESLEY JOHNSON DC (PRESIDENT)
(218) 847-2809
Entity
Organization
Contact information
Practice address
1208 WASHINGTON AVE, DETROIT LAKES, MN 56501-3906
(218) 847-2809
Mailing address
1208 WASHINGTON AVE, DETROIT LAKES, MN 56501-3906
(218) 847-2809
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64868JO
BLUE CROSS BLUE SHIELD
MN
05
—
8347280
—
MN
Enumeration date
02/28/2007
Last updated
09/05/2007
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