MEDICARE: DR. JESSICA LEE DILLEY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4354	OH

General Provider Information

NPI Number	:	1922345693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA LEE DILLEY D.C.

Provider Business Mailing Address
First Line	:	2775 S MORELAND BLVD
Second Line	:	3RD FLOOR
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2397
Country	:	US
Telephone Number	:	216-751-8988
Fax Number	:	216-751-8990

Provider Business Practice Location Address
First Line	:	2775 S MORELAND BLVD
Second Line	:	3RD FLOOR
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2397
Country	:	US
Telephone Number	:	219-751-8988
Fax Number	:	216-751-8990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	07/06/2016

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