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General NPI Number Information
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NPI Number | 1477154466
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Entity Type | Organization
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Legal Business Name | PJJ PLC
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 215 S CEDAR ST
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City | KALKASKA
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State | MI
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Zip | 49646-8058
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Country | US
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Telephone | 231-518-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1398 HOBBS HWY N
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City | TRAVERSE CITY
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State | MI
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Zip | 49696-9310
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Country | US
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Telephone | 231-631-7200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER J. JENEMA
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Credential | DC
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Telephone | 231-518-2000
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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 |
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