Provider Demographics
NPI:1508036344
Name:JC2 ENTERPRISES LLC
Entity Type:Organization
Organization Name:JC2 ENTERPRISES LLC
Other - Org Name:PRECISION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-452-6453
Mailing Address - Street 1:1710 N WHITLEY DR STE C
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619-2183
Mailing Address - Country:US
Mailing Address - Phone:208-452-6453
Mailing Address - Fax:208-452-1217
Practice Address - Street 1:1710 N WHITLEY DR STE C
Practice Address - Street 2:
Practice Address - City:FRUITLAND
Practice Address - State:ID
Practice Address - Zip Code:83619-2183
Practice Address - Country:US
Practice Address - Phone:208-452-6453
Practice Address - Fax:208-452-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-852111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty