Provider Demographics
NPI:1326753047
Name:MOSAIC CHIROPRACTIC AND WOMEN'S HEALTH PLLC
Entity Type:Organization
Organization Name:MOSAIC CHIROPRACTIC AND WOMEN'S HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNA
Authorized Official - Middle Name:SONGER
Authorized Official - Last Name:JORNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ATC
Authorized Official - Phone:913-709-3401
Mailing Address - Street 1:660 E FRANKLIN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2912
Mailing Address - Country:US
Mailing Address - Phone:208-495-5645
Mailing Address - Fax:208-493-4397
Practice Address - Street 1:660 E FRANKLIN RD STE 110
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2912
Practice Address - Country:US
Practice Address - Phone:208-495-5645
Practice Address - Fax:208-493-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty