Provider Demographics
NPI:1992229710
Name:JONES FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:JONES FAMILY CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-526-3343
Mailing Address - Street 1:109 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-1519
Mailing Address - Country:US
Mailing Address - Phone:608-375-2411
Mailing Address - Fax:608-375-2412
Practice Address - Street 1:109 W OAK ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-1519
Practice Address - Country:US
Practice Address - Phone:608-375-2411
Practice Address - Fax:608-375-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1750684304OtherGROUP NPI