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Individual

DR. LARRY DEAN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2721 DEL PRADO BLVD S STE 250, CAPE CORAL, FL 33904-5710
(239) 471-9070
(239) 574-9454
Mailing address
2721 DEL PRADO BLVD S STE 250, CAPE CORAL, FL 33904-5710
(239) 471-9070
(239) 574-9454

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH5495
FL
111NN0400X
Neurology Chiropractor
Primary
CH5495
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350053600
RAILROAD MEDICARE
05
381717200
FL
Enumeration date
02/24/2006
Last updated
04/05/2024
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