Provider Demographics
NPI:1518270297
Name:JONES, ANDREW JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JACOB
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-5900
Mailing Address - Country:US
Mailing Address - Phone:608-526-3343
Mailing Address - Fax:608-526-9366
Practice Address - Street 1:814 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-5900
Practice Address - Country:US
Practice Address - Phone:608-526-3343
Practice Address - Fax:608-526-9366
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI4642-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program