Provider Demographics
NPI:1023564515
Name:JAMESON, DENISE (DC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:JAMESON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-0513
Mailing Address - Country:US
Mailing Address - Phone:231-598-0135
Mailing Address - Fax:
Practice Address - Street 1:712 N 22ND ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-8662
Practice Address - Country:US
Practice Address - Phone:417-413-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015015989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor