Johnson, Gary L
Johnson, Gary L is an sole proprietor health care provider with primary practice located at 2745 Pole Line Road , Pocatello ID 83201-6111. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Johnson, Gary L can be contacted via phone (208) 234-2225.Contact Information
Primary practice address
2745 Pole Line Road
Pocatello ID 83201-6111
Phone: (208) 234-2225
Fax: (208) 478-5556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CHIA -958 | Idaho |
Profile Details
| NPI number | 1588721930 |
|---|---|
| LBN Legal business name | Johnson, Gary L |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Mar 12th, 2024 - about 2 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 | 1588721930 | NPPES |
| Idaho | Other | C2284 | BLUE CROSS ID |
| Idaho | Other | 000010034427 | BLUE CROSS ID |
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