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General NPI Number Information
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NPI Number | 1750684304
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Entity Type | Organization
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Legal Business Name | JONES FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 1150 EMMERS LN
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City | OSHKOSH
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State | WI
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Zip | 54904-7758
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Country | US
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Telephone | 920-267-2651
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 EMMERS LN
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City | OSHKOSH
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State | WI
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Zip | 54904-7758
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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 | OWNER/DOCTOR
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Name | DR. ANDREW JACOB JONES
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Credential | D.C.
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Telephone | 920-267-2651
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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 | 4642-012
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License Number State | WI
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