Provider Demographics
NPI:1669800942
Name:JMJ ENTERPRISES LLC
Entity type:Organization
Organization Name:JMJ ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-781-0331
Mailing Address - Street 1:4716 4TH ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-4900
Mailing Address - Country:US
Mailing Address - Phone:806-224-0063
Mailing Address - Fax:
Practice Address - Street 1:4716 4TH ST
Practice Address - Street 2:STE. 102
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4900
Practice Address - Country:US
Practice Address - Phone:806-224-0063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11305305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization