Johnson, Mary J
Johnson, Mary J is an sole proprietor health care provider with primary practice located at 23624 St Francis Blvd Suite 1, St Francis MN 55070-0399. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Johnson, Mary J can be contacted via phone (763) 753-3126.Contact Information
Primary practice address
23624 St Francis Blvd Suite 1
St Francis MN 55070-0399
Phone: (763) 753-3126
Fax: (763) 753-2808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2663 | Minnesota |
Profile Details
| NPI number | 1710031117 |
|---|---|
| LBN Legal business name | Johnson, Mary J |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Jul 10th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710031117 | NPPES |
| Other | 231258 | CCMI | |
| Other | 4K009J0 | CCMI | |
| Other | 4K008J0 | CCMI | |
| Other | 0125 | CCMI | |
| Other | 4440078 | CCMI | |
| MEDICAID | 817228500 | CCMI |
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