Organization
BACK & BODY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER D JOHNSON D.C. (VICE PRESIDENT)
(952) 239-2936
Entity
Organization
Contact information
Practice address
2020 SILVER BELL RD STE 9, EAGAN, MN 55122-1050
(651) 452-7018
Mailing address
18480 KENYON AVE, LAKEVILLE, MN 55044-6911
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5200
MN
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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