Provider Demographics
NPI:1437967940
Name:HUMPHRIES, JONAH (DC)
Entity type:Individual
Prefix:DR
First Name:JONAH
Middle Name:
Last Name:HUMPHRIES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-0011
Mailing Address - Country:US
Mailing Address - Phone:937-981-1992
Mailing Address - Fax:937-981-1991
Practice Address - Street 1:1460 STATE ROUTE 28 W UNIT A
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-8415
Practice Address - Country:US
Practice Address - Phone:937-981-1992
Practice Address - Fax:937-981-1991
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor