Provider Demographics
NPI:1922177450
Name:MMJS INC
Entity Type:Organization
Organization Name:MMJS INC
Other - Org Name:TOTAL WELLNESS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC PYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAYMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-947-9355
Mailing Address - Street 1:550 OHIO PIKE
Mailing Address - Street 2:SUITE 121-F
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3315
Mailing Address - Country:US
Mailing Address - Phone:513-947-9355
Mailing Address - Fax:513-947-0190
Practice Address - Street 1:550 OHIO PIKE
Practice Address - Street 2:SUITE 121-F
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3315
Practice Address - Country:US
Practice Address - Phone:513-947-9355
Practice Address - Fax:513-947-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2350718Medicaid
OH2350718Medicaid