Provider Demographics
NPI:1851987713
Name:DR JS CHIROPRACTIC WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:DR JS CHIROPRACTIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:L
Authorized Official - Last Name:JAMESON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-389-7301
Mailing Address - Street 1:5002 S 24TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2754
Mailing Address - Country:US
Mailing Address - Phone:402-389-7301
Mailing Address - Fax:
Practice Address - Street 1:5002 S 24TH ST STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2754
Practice Address - Country:US
Practice Address - Phone:402-389-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty