Individual
DR. JEFFERY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1420 S JOPLIN AVE, JOPLIN, MO 64801-4524
(417) 623-8844
Mailing address
1420 S JOPLIN AVE, JOPLIN, MO 64801-4524
(417) 623-8844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1999134933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130909
BC BS
MO
01
—
7773065
AETNA
MO
Enumeration date
03/21/2007
Last updated
07/08/2007
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