Provider Demographics
NPI:1083186969
Name:JKM LLC
Entity Type:Organization
Organization Name:JKM LLC
Other - Org Name:JAYMAC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DEREK
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-264-6800
Mailing Address - Street 1:22711 S ELLSWORTH RD # G106
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6788
Mailing Address - Country:US
Mailing Address - Phone:480-264-6800
Mailing Address - Fax:480-300-4688
Practice Address - Street 1:22711 S ELLSWORTH RD # G106
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6788
Practice Address - Country:US
Practice Address - Phone:480-264-6800
Practice Address - Fax:480-300-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty