Provider Demographics
NPI:1790057198
Name:JONES, JOSHUA RODGERS (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:RODGERS
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:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:EDWARDSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49112-0547
Mailing Address - Country:US
Mailing Address - Phone:269-683-6000
Mailing Address - Fax:269-683-6350
Practice Address - Street 1:69821 M 62
Practice Address - Street 2:STE 12
Practice Address - City:EDWARDSBURG
Practice Address - State:MI
Practice Address - Zip Code:49112-8807
Practice Address - Country:US
Practice Address - Phone:269-683-6000
Practice Address - Fax:269-683-6350
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor