Provider Demographics
NPI:1407992290
Name:STEARN, JESS J (DC)
Entity Type:Individual
Prefix:
First Name:JESS
Middle Name:J
Last Name:STEARN
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 1:6800 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2149
Mailing Address - Country:US
Mailing Address - Phone:954-749-7440
Mailing Address - Fax:954-749-5765
Practice Address - Street 1:6800 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2149
Practice Address - Country:US
Practice Address - Phone:954-749-7440
Practice Address - Fax:954-749-5765
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0002460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89881Medicare UPIN