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Individual

TRAVIS JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
400 2ND ST S STE 165, HUDSON, WI 54016-1593
(715) 808-0723
Mailing address
8147 GLOBE DR STE 100, WOODBURY, MN 55125-3379
(651) 731-0505
(651) 731-0500

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6597
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6597
BLUE CROSS BLUE SHIELD, HEALTH PARTNERS, CIGNA, CHIROCARE
MN
Enumeration date
02/07/2019
Last updated
07/01/2021
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