Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC-04804 | OH |
N | 111NP0017X | Pediatric Chiropractor | DC-04804 | OH |
NPI | 1174181192 |
---|---|
Provider Name | Dr. Saniya Johnson |
First Address | Harrison, OH 45030-2528 |
Second Address | Harrison, OH 45030-2528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2019 |
Last Update Date | 04/06/2019 |