Healthcare Provider Details

I. General information

NPI: 1750686754
Provider Name (Legal Business Name): CHRIS JONES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2011
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 COPPERFIELD CT
CAPE GIRARDEAU MO
63701
US

IV. Provider business mailing address

3307 S CAMERON AVE
TYLER TX
75701-9126
US

V. Phone/Fax

Practice location:
  • Phone: 573-587-6578
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12669
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: