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General NPI Number Information
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NPI Number | 1750537866
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Entity Type | Organization
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Legal Business Name | JO CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 08/09/2008
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE STE 219
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City | LOS ANGELES
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State | CA
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Zip | 90025-5385
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Country | US
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Telephone | 310-445-9597
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Fax |
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Provider Business Mailing Address
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Address Line | 11340 W OLYMPIC BLVD STE 206
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City | LOS ANGELES
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State | CA
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Zip | 90064-1612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAISUKE JO
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Credential |
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Telephone | 310-445-9597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC25147
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License Number State | CA
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