Provider Demographics
NPI:1396418703
Name:J AND J CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:J AND J CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-625-6215
Mailing Address - Street 1:14422 SHORESIDE WAY # 110-805
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4938
Mailing Address - Country:US
Mailing Address - Phone:407-625-6215
Mailing Address - Fax:
Practice Address - Street 1:14422 SHORESIDE WAY # 110-805
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4938
Practice Address - Country:US
Practice Address - Phone:407-625-6215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center