MEDICARE: SJBJ PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1106	MS

General Provider Information

NPI Number	:	1104361039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SJBJ PLLC

Provider Business Mailing Address
First Line	:	2013 HIGHWAY 45 N STE 1
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2239
Country	:	US
Telephone Number	:	662-327-6586
Fax Number	:	662-327-6587

Provider Business Practice Location Address
First Line	:	2013 HIGHWAY 45 N STE 1
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2239
Country	:	US
Telephone Number	:	662-327-6586
Fax Number	:	662-327-6587

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHANA JO THOMAS
Credential	:	D.C.
Telephone Number	:	662-327-6586

Provider Enumeration Date	:	01/02/2017
Last Update Date	:	11/17/2022

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