Organization
JOHNSON FAMILY CHIROPRACTIC & SPORTS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L JOHNSON DC (OWNER)
(208) 234-2225
Entity
Organization
Contact information
Practice address
2745 POLE LINE RD, POCATELLO, ID 83201-6111
(208) 234-2225
Mailing address
2745 POLE LINE RD, POCATELLO, ID 83201-6111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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