Healthcare Provider Details

I. General information

NPI: 1811410897
Provider Name (Legal Business Name): JONATHAN COURTNEY JUNG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 JENKS AVE STE C
PANAMA CITY FL
32401-2569
US

IV. Provider business mailing address

801 JENKS AVE STE C
PANAMA CITY FL
32401-2569
US

V. Phone/Fax

Practice location:
  • Phone: 520-256-5919
  • Fax:
Mailing address:
  • Phone: 850-812-8026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH12206
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13239
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: