Provider Demographics
NPI:1225250806
Name:WAITKEVICH, JESSICA RACHEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RACHEL
Last Name:WAITKEVICH
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 1:110 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19056-1552
Mailing Address - Country:US
Mailing Address - Phone:215-378-9021
Mailing Address - Fax:
Practice Address - Street 1:110 TERRACE RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-1552
Practice Address - Country:US
Practice Address - Phone:215-378-9021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor