MEDICARE: 2J CHIROPRACTIC

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

General Provider Information

NPI Number	:	1184258675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	2J CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1120 N BREAZEALE AVE
Second Line	:
City	:	MOUNT OLIVE
State	:	NC
Zip	:	28365-1121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 N BREAZEALE AVE
Second Line	:
City	:	MOUNT OLIVE
State	:	NC
Zip	:	28365-1121
Country	:	US
Telephone Number	:	919-299-8033
Fax Number	:

Authorized Official
Title or Position	:	INSURANCE
Name	:	LARAMIE JONES
Credential	:
Telephone Number	:	919-299-8033

Provider Enumeration Date	:	02/24/2020
Last Update Date	:	05/04/2020

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Directions to “2J CHIROPRACTIC ” Practice Location

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