Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CHIR004755 | GA |
NPI | 1275589335 |
---|---|
Provider Name | Dr. Warren T Jahn |
First Address | Cumming, GA 30041-5546 |
Second Address | Fort Benning, GA 31905-5648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 10/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35ZCDTB | (02) | GA |