Provider Demographics
NPI:1861587370
Name:DAVIS, JESSE (DC)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:
Last Name:DAVIS
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 1:11 E EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3520
Mailing Address - Country:US
Mailing Address - Phone:978-473-2611
Mailing Address - Fax:
Practice Address - Street 1:11 E EMERSON ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3520
Practice Address - Country:US
Practice Address - Phone:781-288-5488
Practice Address - Fax:888-410-8287
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor