Healthcare Provider Details

I. General information

NPI: 1598203101
Provider Name (Legal Business Name): JEFFREY ANDREW CHESSON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 GREENVILLE BLVD SE SUITE B
GREENVILLE NC
27858-6740
US

IV. Provider business mailing address

120 CHANDLER DR APT E
GREENVILLE NC
27834-6078
US

V. Phone/Fax

Practice location:
  • Phone: 252-565-8812
  • Fax:
Mailing address:
  • Phone: 252-312-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP16947
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: