Provider Demographics
NPI:1720419377
Name:WHEELER, JESSICA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 N HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-9743
Mailing Address - Country:US
Mailing Address - Phone:850-785-8311
Mailing Address - Fax:850-872-9892
Practice Address - Street 1:3613 N HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-9743
Practice Address - Country:US
Practice Address - Phone:850-785-8311
Practice Address - Fax:850-872-9892
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10969111N00000X
OH4322111N00000X
MO2012005141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor