Provider Demographics
NPI:1386035368
Name:J M HOLDING GROUP INC
Entity Type:Organization
Organization Name:J M HOLDING GROUP INC
Other - Org Name:CHIROMED ANDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-649-1991
Mailing Address - Street 1:1541 S SCATTERFIELD RD
Mailing Address - Street 2:STE A
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-5785
Mailing Address - Country:US
Mailing Address - Phone:765-649-1991
Mailing Address - Fax:765-649-3383
Practice Address - Street 1:1541 S SCATTERFIELD RD
Practice Address - Street 2:STE A
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-5785
Practice Address - Country:US
Practice Address - Phone:765-649-1991
Practice Address - Fax:765-649-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN111N00000X, 363LP2300X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty