Provider Demographics
NPI:1194242941
Name:JTCHIRO, INC
Entity type:Organization
Organization Name:JTCHIRO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MONFRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-822-4476
Mailing Address - Street 1:N61W23198 SILVER SPRING DR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3935
Mailing Address - Country:US
Mailing Address - Phone:262-822-4476
Mailing Address - Fax:
Practice Address - Street 1:N61W23198 SILVER SPRING DR
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3935
Practice Address - Country:US
Practice Address - Phone:262-822-4476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty