Healthcare Provider Details

I. General information

NPI: 1760305528
Provider Name (Legal Business Name): KHENADI JONES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 APACHE DR
FREMONT MI
49412-1705
US

IV. Provider business mailing address

2022 MILLS AVE
MUSKEGON MI
49445-3120
US

V. Phone/Fax

Practice location:
  • Phone: 231-923-3456
  • Fax:
Mailing address:
  • Phone: 231-924-3456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401680
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: