Provider Demographics
NPI:1508890575
Name:JETER ENTERPRISES INC
Entity Type:Organization
Organization Name:JETER ENTERPRISES INC
Other - Org Name:JETER CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:JETER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-549-2225
Mailing Address - Street 1:615 CAPE CORAL PKWY W
Mailing Address - Street 2:SUITE #105
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6593
Mailing Address - Country:US
Mailing Address - Phone:239-549-2225
Mailing Address - Fax:239-549-2265
Practice Address - Street 1:615 CAPE CORAL PKWY W
Practice Address - Street 2:SUITE #105
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6593
Practice Address - Country:US
Practice Address - Phone:239-549-2225
Practice Address - Fax:239-549-2265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006411261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center