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Individual

ROGER MICHAEL JOHNIGK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
205 COWLITZ STREET, TOLEDO, WA 98591
(360) 864-6666
(360) 864-2077
Mailing address
PO BOX 339, TOLEDO, WA 98591-0339
(360) 864-6666
(360) 864-2077

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
987
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14972
LABOR & INDUSTRIES
WA
05
2001006
WA
Enumeration date
02/20/2007
Last updated
11/04/2011
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