Johnson, Bruce Edward

Johnson, Bruce Edward is an sole proprietor health care provider with primary practice located at 4627 W Homefield Dr , Sioux Falls SD 57106-3511. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Johnson, Bruce Edward can be contacted via phone (605) 336-2010.

Contact Information

Primary practice address
4627 W Homefield Dr Sioux Falls SD 57106-3511
Phone: (605) 336-2010
Fax: (605) 336-0249
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 602 South Dakota

Profile Details

NPI number 1316927288
LBN Legal business name Johnson, Bruce Edward
Credentials CHIROPRACTOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2006
Last updated Nov 6th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316927288 NPPES
South Dakota Other 20860 SIOUX VALLEY HEALTH PLAN
South Dakota Other 248015 SIOUX VALLEY HEALTH PLAN
South Dakota Other 4994546 SIOUX VALLEY HEALTH PLAN
South Dakota MEDICAID 7600882 SIOUX VALLEY HEALTH PLAN

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