Individual
DR. CHARLSEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3240 15TH ST S STE C, FARGO, ND 58104-6188
(701) 451-9070
Mailing address
4425 WESTPORT PKWY, WEST FARGO, ND 58078-8844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1058
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MP00948558
NCMIC
—
Enumeration date
07/18/2017
Last updated
11/16/2017
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