Individual
MR. KEVIN DOUGLAS JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
160 LEWIS PARK DR, MT ZION, IL 62549-1202
(217) 864-5954
(217) 864-6362
Mailing address
160 LEWIS PARK DR, MT ZION, IL 62549-1202
(217) 864-5954
(217) 864-6362
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350046226
RR MEDICARE
—
Enumeration date
07/31/2006
Last updated
04/28/2016
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