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NPI Code Detail

MEDICARE: JIREH CHIROPRACTIC LLC

MEDICARE: JIREH CHIROPRACTIC LLC
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
1111NI0013XIndependent Medical Examiner Chiropractor

General Provider Information

NPI Number : 1952165573
Entity Type Code : Organization
Provider Name (Legal Business Name) : JIREH CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 1822 DREW ST
Second Line :
City : CLEARWATER
State : FL
Zip : 33765-2921
Country : US
Telephone Number : 765-318-9797
Fax Number :
Provider Business Practice Location Address
First Line : 1822 DREW ST
Second Line :
City : CLEARWATER
State : FL
Zip : 33765-2921
Country : US
Telephone Number : 765-318-9797
Fax Number :
Authorized Official
Title or Position : OWNER, CHIROPRACTOR
Name : DR. JONATHAN W HODSON
Credential : DC
Telephone Number : 765-318-9797
Provider Enumeration Date : 02/13/2024
Last Update Date : 02/13/2024

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Directions to “JIREH CHIROPRACTIC LLC ” Practice Location

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