MEDICARE: DR. JIMMIE L JONES DC PC

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	2301004430	MI

General Provider Information

NPI Number	:	1689859076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JIMMIE L JONES DC PC

Provider Business Mailing Address
First Line	:	5122 PASADENA AVE
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2417
Country	:	US
Telephone Number	:	810-733-0139
Fax Number	:	810-733-0512

Provider Business Practice Location Address
First Line	:	5122 PASADENA AVE
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2417
Country	:	US
Telephone Number	:	810-733-0139
Fax Number	:	810-733-0512

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. JIMMIE LEON JONES
Credential	:	DC
Telephone Number	:	810-733-0139

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	06/03/2019

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