Provider Demographics
NPI:1629190293
Name:JOKERST CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:JOKERST CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOKERST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-635-2225
Mailing Address - Street 1:751 W STADIUM BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-4776
Mailing Address - Country:US
Mailing Address - Phone:573-635-2225
Mailing Address - Fax:573-634-5155
Practice Address - Street 1:751 W STADIUM BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-4776
Practice Address - Country:US
Practice Address - Phone:573-635-2225
Practice Address - Fax:573-634-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty