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Individual

DR. ERIC U JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1185 MOUNT AETNA RD, SUITE 102, HAGERSTOWN, MD 21740-6832
(301) 739-0790
(301) 739-0353
Mailing address
226 VENICE WAY, SHEPHERDSTOWN, WV 25443-4648
(304) 876-0500

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01325
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
095990
AETNA
MD
01
1017515
BRICKSTREET
WV
01
220619
MAMSI MDIPA OPT CHC ALLIA
MD
01
41578
IWIF
MD
01
609578
ACN
MD
01
EJ1004587
ASHN
MD
01
R155
BLUECHOICE FEP
MD
Enumeration date
02/21/2007
Last updated
07/08/2007
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