Provider Demographics
NPI:1831150176
Name:JONES, CLINTON (DC)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:
Last Name:JONES
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 1:18107 SHERMAN WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4582
Mailing Address - Country:US
Mailing Address - Phone:818-654-9383
Mailing Address - Fax:818-654-9385
Practice Address - Street 1:18107 SHERMAN WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4582
Practice Address - Country:US
Practice Address - Phone:818-654-9383
Practice Address - Fax:818-654-9385
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor