Provider Demographics
NPI:1467608455
Name:JESSOP, DARRIN R (DC)
Entity Type:Individual
Prefix:
First Name:DARRIN
Middle Name:R
Last Name:JESSOP
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 1:8950 US HIGHWAY 64
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4566
Mailing Address - Country:US
Mailing Address - Phone:901-388-0737
Mailing Address - Fax:901-755-9605
Practice Address - Street 1:8950 US HIGHWAY 64
Practice Address - Street 2:SUITE 109
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-4566
Practice Address - Country:US
Practice Address - Phone:901-388-0737
Practice Address - Fax:901-755-9605
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor