Healthcare Provider Details

I. General information

NPI: 1447865050
Provider Name (Legal Business Name): ACTIVE HEALTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 S MAIN ST
JOPLIN MO
64801-4501
US

IV. Provider business mailing address

719 S MAIN ST
JOPLIN MO
64801-4501
US

V. Phone/Fax

Practice location:
  • Phone: 417-781-9300
  • Fax: 417-720-2679
Mailing address:
  • Phone: 417-781-9300
  • Fax: 417-720-2679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. AUSTIN RAY JONES
Title or Position: OWNER
Credential: DC
Phone: 417-781-9300