Basic Information
| Provider Information | |||||||||
| NPI: | 1467476507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | JOHNNY | ||||||||
| MiddleName: | GENE | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23394 JACOBSON RD | ||||||||
| Address2: | |||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346014813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526868230 | ||||||||
| FaxNumber: | 3526868240 | ||||||||
| Practice Location | |||||||||
| Address1: | 11079 SPRING HILL DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346085000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526868230 | ||||||||
| FaxNumber: | 3526886240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 11/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | CH5575 | FL | Y | Chiropractic Providers | Chiropractor |
No ID Information.