Provider Demographics
NPI:1538501119
Name:PELL, JESSICA JO (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JO
Last Name:PELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:JO
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27999 OLD STH WALKER RD STE B
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6048
Mailing Address - Country:US
Mailing Address - Phone:225-271-4083
Mailing Address - Fax:225-271-4208
Practice Address - Street 1:27999 OLD STH WALKER RD STE B
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6048
Practice Address - Country:US
Practice Address - Phone:225-271-4083
Practice Address - Fax:225-271-4208
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002729A111N00000X
LA1881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor