Provider Demographics
NPI:1811410897
Name:JUNG, JONATHAN COURTNEY (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:COURTNEY
Last Name:JUNG
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 1:1328 JENKS AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2591
Mailing Address - Country:US
Mailing Address - Phone:850-812-8026
Mailing Address - Fax:
Practice Address - Street 1:2423 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4405
Practice Address - Country:US
Practice Address - Phone:520-256-5919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13239111N00000X
FLCH12206111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor