Provider Demographics
NPI:1619743762
Name:JIS CHIROPRACTIC & ACUPUNCTURE P.C
Entity Type:Organization
Organization Name:JIS CHIROPRACTIC & ACUPUNCTURE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JI
Authorized Official - Middle Name:HOON
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:929-702-4763
Mailing Address - Street 1:330 W 38TH ST RM 208
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-8425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 W 38TH ST RM 208
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-8425
Practice Address - Country:US
Practice Address - Phone:929-702-4763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty