Individual
JOSHUA LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
310 SUSAN DR., NORMAL, IL 61761
(636) 328-4939
Mailing address
5278 E QUEENWOOD RD, GROVELAND, IL 61535-9613
(636) 328-4939
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011514
IL
111N00000X
Chiropractor
27-2998137
IL
Other
Enumeration date
07/12/2010
Last updated
08/11/2010
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