NPI 1417825480 · live from the CMS NPI Registry
Coleman Jace Johnson, DC
Chiropractor in Gillette, WY. National Provider Identifier 1417825480, active.
NPI record
| NPI | 1417825480 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Chiropractor 111N00000X |
| Practice location | 3314 Tee Ct, Gillette, WY 82718 |
| Practice phone | 307-689-5974 |
| Mailing address | Po Box 1268, Gillette, WY 82717 |
| Enumerated | October 29, 2025 |
| Last updated | October 29, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor primary | 111N00000X | 878 (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.