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Individual

DR. NEIL JORDAN KJOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3536 CUMMINGS HWY, STE. 120, CHATTANOOGA, TN 37419-2435
(423) 825-5252
(423) 825-1228
Mailing address
3536 CUMMINGS HWY, STE. 120, CHATTANOOGA, TN 37419-2435
(423) 825-5252
(423) 825-1228

Taxonomy

Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
1430
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000933226A
GA
01
3069538
BLUE CROSS PIN
TN
01
350052346
RAILROAD MC/PALMETTO GBA
GA
01
5011638
AETNA PIN
TN
01
621713923
TAX ID NO.
TN
Enumeration date
09/29/2005
Last updated
11/30/2010
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