Provider Demographics
NPI:1841468006
Name:JENKINS CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:JENKINS CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JEFFERSON
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-775-0550
Mailing Address - Street 1:37 S HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3317
Mailing Address - Country:US
Mailing Address - Phone:740-775-0550
Mailing Address - Fax:740-775-0552
Practice Address - Street 1:37 S HICKORY ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3317
Practice Address - Country:US
Practice Address - Phone:740-775-0550
Practice Address - Fax:740-775-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH301500669001OtherMEDICAL MUTUAL OF OHIO
OH4400286OtherUNITED HEALTHCARE
OH0811581Medicaid
OH000000120416OtherANTHEM BLUE CROSS/BLUE SH
OH0811581Medicaid
OH4400286OtherUNITED HEALTHCARE