Provider Demographics
NPI:1922813559
Name:MARK JOHNSON CHIROPRACTIC PSC
Entity type:Organization
Organization Name:MARK JOHNSON CHIROPRACTIC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BROOK
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BATEY-HEIM
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:810-429-1805
Mailing Address - Street 1:3955 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-2027
Mailing Address - Country:US
Mailing Address - Phone:859-431-4430
Mailing Address - Fax:
Practice Address - Street 1:3955 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-2027
Practice Address - Country:US
Practice Address - Phone:859-431-4430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center