Jcc LLC

NPI #1649448374 in Phoenix, Maryland

Provider Information

NPI Number: 1649448374
Entity Type: Organization
Organization Name: Jcc LLC
Primary Specialty: Chiropractor
Enumeration Date: Feb 15, 2008
Last Updated: Feb 15, 2008

Practice Location

Address: 14307 JARRETTSVILLE PIKE
City: Phoenix
State: Maryland
ZIP Code: 21131-1763
Phone: (410) 592-7300

Authorized Official

Name: DR. DANIEL THOMAS WISE, D.C.
Title: DOCTOR/OWNER
Phone: (410) 592-7300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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