Provider Demographics
NPI:1780711036
Name:DINKLE, JON ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:ROBERT
Last Name:DINKLE
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 1:420 W BASELINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-4817
Mailing Address - Country:US
Mailing Address - Phone:626-852-1000
Mailing Address - Fax:626-852-2338
Practice Address - Street 1:420 W BASELINE RD STE A
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-4817
Practice Address - Country:US
Practice Address - Phone:626-852-1000
Practice Address - Fax:626-852-2338
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor