Provider Demographics
NPI:1073519062
Name:POWELL, JEFFREY ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:POWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-9024
Mailing Address - Country:US
Mailing Address - Phone:828-396-2163
Mailing Address - Fax:282-396-4177
Practice Address - Street 1:3330 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-9024
Practice Address - Country:US
Practice Address - Phone:828-396-2163
Practice Address - Fax:282-396-4177
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-18
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NC2594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor