Provider Demographics
NPI:1336551514
Name:JON CHAMBERS CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:JON CHAMBERS CHIROPRACTIC, LLC
Other - Org Name:THE NEURO CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:APPLEGATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-479-1289
Mailing Address - Street 1:1215 NE 7TH STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526
Mailing Address - Country:US
Mailing Address - Phone:541-479-1289
Mailing Address - Fax:888-640-1719
Practice Address - Street 1:1215 NE 7TH STREET
Practice Address - Street 2:SUITE F
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526
Practice Address - Country:US
Practice Address - Phone:541-479-1289
Practice Address - Fax:888-640-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty