Provider Demographics
NPI:1518693324
Name:HYNEK, JESSE (DC)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:HYNEK
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 1:116 1/2 E WASHINGTON ST.
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:IA
Mailing Address - Zip Code:52301-7530
Mailing Address - Country:US
Mailing Address - Phone:319-654-4861
Mailing Address - Fax:
Practice Address - Street 1:3800 RIVER RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7530
Practice Address - Country:US
Practice Address - Phone:319-393-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor