J Pol Wellness LLC – Chiropractor in Affton, MO

Key facts

NPI: 1629499728
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 2013033420 (MO)
Legal business name: J POL WELLNESS LLC
Practice address: 8005 Mackenzie Rd
Affton, MO 63123-3518
Phone: (314) 353-4500
NPI assigned: Dec 17, 2013
Organization subpart: No

Authorized official

Name: Dr. Jesse Daniel Politowski, DC
Title: Owner/Doctor
Phone: (314) 353-4500

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	2013033420	MO	Yes

Addresses

Primary practice location

8005 Mackenzie Rd
Affton, MO 63123-3518

Mailing address

8005 Mackenzie Rd
Affton, MO 63123-3518
Phone (314) 353-4500

Other names

Spine and Joint Center of Affton Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 17, 2013.

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1629499728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8005 MACKENZIE RD",
            "city": "AFFTON",
            "state": "MO",
            "postal_code": "631233518",
            "telephone_number": "314-353-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8005 MACKENZIE RD",
            "city": "AFFTON",
            "state": "MO",
            "postal_code": "631233518",
            "telephone_number": "314-353-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J POL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "POLITOWSKI",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "314-353-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2013033420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine and Joint Center of Affton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Affton, MO

All providers in Affton, MO · Chiropractor in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.