Provider Demographics
NPI:1639444979
Name:JONES, BENJAMIN S (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:S
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 1:1496 POPE CT STE 3
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-5303
Mailing Address - Country:US
Mailing Address - Phone:219-926-8522
Mailing Address - Fax:219-926-7513
Practice Address - Street 1:1496 POPE CT STE 3
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-5303
Practice Address - Country:US
Practice Address - Phone:219-926-8522
Practice Address - Fax:219-926-7513
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002627A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor