Provider Demographics
NPI:1134525918
Name:JMP CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:JMP CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PLENTL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-251-9024
Mailing Address - Street 1:831 N ATKERSON LN
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4707
Mailing Address - Country:US
Mailing Address - Phone:817-251-9024
Mailing Address - Fax:817-251-9057
Practice Address - Street 1:6409 COLLEYVILLE BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6224
Practice Address - Country:US
Practice Address - Phone:817-251-9024
Practice Address - Fax:817-251-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty