Individual
KRISTEN MARIE JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
6852 W 111TH ST, WORTH, IL 60482-1823
(708) 448-3818
(708) 448-3804
Mailing address
6852 W 111TH ST, WORTH, IL 60482-1823
(708) 448-3818
(708) 448-3804
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-008775
IL
Other
Enumeration date
04/03/2007
Last updated
10/15/2009
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