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General NPI Number Information
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NPI Number | 1174926026
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Entity Type | Organization
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Legal Business Name | MCJJ HOLDINGS
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 11216 MANCHESTER ROAD
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City | KIRKWOOD
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State | MO
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Zip | 63122
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Country | US
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Telephone | 314-394-2093
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Fax |
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Provider Business Mailing Address
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Address Line | 11216 MANCHESTER ROAD
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City | KIRKWOOD
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State | MO
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Zip | 63122
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Country | US
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Telephone | 314-496-3790
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. JAMES W HANKINSON
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Credential | D.C
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Telephone | 314-394-2093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | MO
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