Individual
DR. NEIL JORDAN KJOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
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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