Edward Johnnie, DC | |
1137 N Main St Ste 1, O Fallon, MO 63366-1498 | |
(636) 294-4530 | |
Not Available |
Full Name | Edward Johnnie |
---|---|
Gender | Male |
Speciality | Chiropractic |
Experience | 25 Years |
Location | 1137 N Main St Ste 1, O Fallon, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528096054 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2000146684 (Missouri) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Logan University | 5698660322 | 10 |
Provider Name | Logan University |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1194765941 PECOS PAC ID: 5698660322 Enrollment ID: O20040220000119 |
Provider Name | E.d. Johnnie Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1740567577 PECOS PAC ID: 2062689821 Enrollment ID: O20120118000737 |
Mailing Address | Practice Location Address |
---|---|
Edward Johnnie, DC 1548 Wainscott Dr, O Fallon, MO 63366-4481 Ph: (636) 734-7569 | Edward Johnnie, DC 1137 N Main St Ste 1, O Fallon, MO 63366-1498 Ph: (636) 294-4530 |
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