Provider Demographics
NPI:1407942576
Name:HESS, JEREMY ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:ADAM
Last Name:HESS
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 1:5430 N HENRY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3269
Mailing Address - Country:US
Mailing Address - Phone:770-389-4744
Mailing Address - Fax:770-389-4760
Practice Address - Street 1:5532 N HENRY BLVD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3220
Practice Address - Country:US
Practice Address - Phone:770-389-4744
Practice Address - Fax:770-389-4760
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU81911Medicare UPIN