Organization
CEDAR LAKE CHIROPRACTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARRETT DALE JOHNSON D.C. (PRESIDENT/DOCTOR)
(228) 392-4000
Entity
Organization
Contact information
Practice address
935 CEDAR LAKE RD, BILOXI, MS 39532-2128
(228) 392-4000
(228) 392-4001
Mailing address
935 CEDAR LAKE RD, BILOXI, MS 39532-2128
(228) 392-4000
(228) 392-4001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1052
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02733326
—
MS
Enumeration date
12/05/2012
Last updated
12/05/2012
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