Provider Demographics
NPI:1548310121
Name:HESSON, JEAN KAREN (DC)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:KAREN
Last Name:HESSON
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 1:6250 GRAND CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26105-8924
Mailing Address - Country:US
Mailing Address - Phone:304-481-4751
Mailing Address - Fax:
Practice Address - Street 1:6250 GRAND CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-8924
Practice Address - Country:US
Practice Address - Phone:304-481-4751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU90454Medicare UPIN
NYDD1300 B772Medicare ID - Type Unspecified