Johnson, Mary Jo
Johnson, Mary Jo is an individual health care provider with primary practice located at 1305 W 96Th St Suite C, Indianapolis IN 46260-1192. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Johnson, Mary Jo can be contacted via phone (317) 580-9867.Contact Information
Primary practice address
1305 W 96Th St Suite C
Indianapolis IN 46260-1192
Phone: (317) 580-9867
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 08001438A | Indiana |
Profile Details
| NPI number | 1851383491 |
|---|---|
| LBN Legal business name | Johnson, Mary Jo |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Aug 8th, 2023 - about 3 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 | 1851383491 | NPPES |
| Indiana | MEDICAID | 100216510A | |
| Indiana | Other | 000000189532 | |
| Indiana | Other | 645867 |
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