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General NPI Number Information
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NPI Number | 1922345230
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Entity Type | Organization
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Legal Business Name | JCMT ENTERPRISES LLC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 6499 S MASON MONTGOMERY RD SUITE D
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City | MASON
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State | OH
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Zip | 45040-1764
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Country | US
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Telephone | 330-469-4411
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 131
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City | KINGS MILLS
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State | OH
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Zip | 45034-0131
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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 | MANAGER/MEMBER
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Name | DR. JASON THOMAS COE
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Credential | D.C.
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Telephone | 330-469-4411
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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 | 4242
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License Number State | OH
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