Provider Demographics
NPI:1609342526
Name:DEJESSE CORP
Entity Type:Organization
Organization Name:DEJESSE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:CIMA
Authorized Official - Last Name:DEJESSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-310-8665
Mailing Address - Street 1:10800 N MILITARY TRL STE 111
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6527
Mailing Address - Country:US
Mailing Address - Phone:561-775-9111
Mailing Address - Fax:
Practice Address - Street 1:10800 N MILITARY TRL STE 111
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6527
Practice Address - Country:US
Practice Address - Phone:561-775-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty