MEDICARE: JM CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5607	MN

General Provider Information

NPI Number	:	1639438922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JM CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	705 WASHINGTON AVE S
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56601-4838
Country	:	US
Telephone Number	:	218-444-2070
Fax Number	:	218-444-8091

Provider Business Practice Location Address
First Line	:	705 WASHINGTON AVE S
Second Line	:
City	:	BEMIDJI
State	:	MN
Zip	:	56601-4838
Country	:	US
Telephone Number	:	218-444-2070
Fax Number	:	218-444-8091

Authorized Official
Title or Position	:	SOLE MEMBER/OWNER
Name	:	JENNA MAHS
Credential	:	D.C.
Telephone Number	:	218-444-2070

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	08/30/2021

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Directions to “JM CHIROPRACTIC LLC ” Practice Location

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