Provider Demographics
NPI:1629265830
Name:HAMMEL, JESSE SETH (DOM)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:SETH
Last Name:HAMMEL
Suffix:
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 LYTLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-4531
Mailing Address - Country:US
Mailing Address - Phone:561-585-6692
Mailing Address - Fax:561-582-6174
Practice Address - Street 1:1650 NE 26TH ST
Practice Address - Street 2:#101
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1431
Practice Address - Country:US
Practice Address - Phone:954-564-6573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2464171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist