Provider Demographics
NPI:1376628487
Name:NESS, JEFFREY PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PHILIP
Last Name:NESS
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 1:214 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-1853
Mailing Address - Country:US
Mailing Address - Phone:636-583-5775
Mailing Address - Fax:
Practice Address - Street 1:214 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1853
Practice Address - Country:US
Practice Address - Phone:636-583-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE0004733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT43446Medicare UPIN