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General NPI Number Information
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NPI Number | 1437967940
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Entity Type | Individual
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Provider Name | JONAH HUMPHRIES DC
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Gender | Male
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 1460 STATE ROUTE 28 W UNIT A
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City | GREENFIELD
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State | OH
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Zip | 45123-8415
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Country | US
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Telephone | 937-981-1992
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Fax | 937-981-1991
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Provider Business Mailing Address
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Address Line | PO BOX 11
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City | GREENFIELD
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State | OH
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Zip | 45123-0011
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Country | US
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Telephone | 937-981-1992
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Fax | 937-981-1991
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC-05413
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License Number State | OH
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