| Organization Name: | JMJ3 HERITAGE, L.L.C. |
| NPI Number: | 1548681950 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NAOMI CHELLI (ORGANIZER) |
| Mailing Address: | 3800 Commerce Blvd Davenport |
| State: | IA US |
| Postal Code: | 528073495 |
| Phone Number: | 5633221888 |
| Fax Number: | |
| NPI Enumeration Date: | 01/02/2014 |
| NPI Last Update Date: | 01/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 35355 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |