Provider Demographics
NPI:1154524346
Name:JONES CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:JONES CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-929-3700
Mailing Address - Street 1:801 E WATAUGA AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4113
Mailing Address - Country:US
Mailing Address - Phone:423-929-3700
Mailing Address - Fax:423-929-8780
Practice Address - Street 1:801 E WATAUGA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4113
Practice Address - Country:US
Practice Address - Phone:423-929-3700
Practice Address - Fax:423-929-8780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JONES CHIROPRACTIC CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-06
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3678611Medicare ID - Type Unspecified