Provider Demographics
NPI:1215040639
Name:JEON, JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:JEON
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 1:2360 STATE ROUTE 89
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-9425
Mailing Address - Country:US
Mailing Address - Phone:315-651-2640
Mailing Address - Fax:
Practice Address - Street 1:2360 STATE ROUTE 89
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-9425
Practice Address - Country:US
Practice Address - Phone:315-651-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor