Provider Demographics
NPI:1184665176
Name:JONES, JUDY L (DC)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:L
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2181 OLYMPIC ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2767
Mailing Address - Country:US
Mailing Address - Phone:937-390-9080
Mailing Address - Fax:937-390-9075
Practice Address - Street 1:2181 OLYMPIC ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2767
Practice Address - Country:US
Practice Address - Phone:937-390-9080
Practice Address - Fax:937-390-9075
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU25775Medicare UPIN