Provider Demographics
NPI:1811405988
Name:MACKENZIE J JONES PLLC
Entity Type:Organization
Organization Name:MACKENZIE J JONES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-721-8264
Mailing Address - Street 1:109 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:SURREY
Mailing Address - State:ND
Mailing Address - Zip Code:58785-7134
Mailing Address - Country:US
Mailing Address - Phone:701-721-8264
Mailing Address - Fax:
Practice Address - Street 1:1407 S BROADWAY STE 123
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-721-8264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN722753OtherMEDICARE
ND81179Medicaid