Provider Demographics
NPI:1316487481
Name:JOHNSON, ERIKA KAY (DC)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:KAY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-8827
Mailing Address - Country:US
Mailing Address - Phone:317-508-3177
Mailing Address - Fax:
Practice Address - Street 1:1111 N LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-1760
Practice Address - Country:US
Practice Address - Phone:765-482-8181
Practice Address - Fax:765-482-8183
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002918A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor