Provider Demographics
NPI:1851163505
Name:JWB CHIROPRACTIC PC
Entity Type:Organization
Organization Name:JWB CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-459-0780
Mailing Address - Street 1:13353 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3108
Mailing Address - Country:US
Mailing Address - Phone:314-200-4955
Mailing Address - Fax:314-962-7874
Practice Address - Street 1:13353 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3108
Practice Address - Country:US
Practice Address - Phone:314-200-4955
Practice Address - Fax:314-962-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty