Provider Demographics
NPI:1881977064
Name:MEAD, JESSE CARMEN (DC)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:CARMEN
Last Name:MEAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3599
Mailing Address - Country:US
Mailing Address - Phone:603-749-3333
Mailing Address - Fax:
Practice Address - Street 1:627 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3599
Practice Address - Country:US
Practice Address - Phone:603-749-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2312111N00000X
MA3352111N00000X
NH1212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor