Provider Demographics
NPI:1508396979
Name:JSB LLC
Entity Type:Organization
Organization Name:JSB LLC
Other - Org Name:NATURAL WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-387-6333
Mailing Address - Street 1:5615 251ST ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2117
Mailing Address - Country:US
Mailing Address - Phone:516-387-6333
Mailing Address - Fax:718-639-1233
Practice Address - Street 1:5615 251ST ST STE 1
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2117
Practice Address - Country:US
Practice Address - Phone:516-387-6333
Practice Address - Fax:718-639-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty