Provider Demographics
NPI:1962035279
Name:JONES, CHRISTOPHER GLENN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GLENN
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:N63W23524 SILVER SPRING DR STOP 4
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3897
Mailing Address - Country:US
Mailing Address - Phone:262-409-6754
Mailing Address - Fax:262-246-8894
Practice Address - Street 1:N63W23524 SILVER SPRING DR STOP 4
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3897
Practice Address - Country:US
Practice Address - Phone:262-409-6754
Practice Address - Fax:262-246-8894
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-14
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5518-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor