Individual
DR. MICHAEL LAFAYETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6TH W. BRIDGE ST., BLACKFOOT, ID 83221
(208) 785-0832
Mailing address
6TH W. BRIDGE ST., BLACKFOOT, ID 83221
(208) 785-0832
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1075
ID
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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