Provider Demographics
NPI:1598203101
Name:CHESSON, JEFFREY ANDREW (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:CHESSON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CHANDLER DR
Mailing Address - Street 2:APT E
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6078
Mailing Address - Country:US
Mailing Address - Phone:252-312-9771
Mailing Address - Fax:
Practice Address - Street 1:518 GREENVILLE BLVD SE
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-6740
Practice Address - Country:US
Practice Address - Phone:252-565-8812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist