MEDICARE: CLINTON JONES D.C.

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	DC13807	CA

General Provider Information

NPI Number	:	1831150176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON JONES D.C.

Provider Business Mailing Address
First Line	:	18107 SHERMAN WAY
Second Line	:	SUITE 200
City	:	RESEDA
State	:	CA
Zip	:	91335-4582
Country	:	US
Telephone Number	:	818-654-9383
Fax Number	:	818-654-9385

Provider Business Practice Location Address
First Line	:	18107 SHERMAN WAY
Second Line	:	SUITE 200
City	:	RESEDA
State	:	CA
Zip	:	91335-4582
Country	:	US
Telephone Number	:	818-654-9383
Fax Number	:	818-654-9385

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	07/08/2007

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Directions to “ CLINTON JONES D.C.” Practice Location

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