Healthcare Provider Details

I. General information

NPI: 1346399326
Provider Name (Legal Business Name): JONES CHIROPRACTIC AND PHYSICAL THERAPY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 S WASHINGTON
BUNKER HILL IL
62014
US

IV. Provider business mailing address

PO BOX 326 721 S WASHINGTON
BUNKER HILL IL
62014
US

V. Phone/Fax

Practice location:
  • Phone: 618-585-3522
  • Fax: 618-585-3522
Mailing address:
  • Phone: 618-585-3522
  • Fax: 618-585-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL JONES
Title or Position: PRESIDENT
Credential: DC
Phone: 618-585-3522