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General NPI Number Information
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NPI Number | 1093773749
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Entity Type | Individual
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Provider Name | JOHN ASHLEY DEESE DC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 812 CANDY PARK RD SUITE 6103
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City | PEMBROKE
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State | NC
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Zip | 28372-9129
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Country | US
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Telephone | 910-521-3093
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Fax | 910-521-3095
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Provider Business Mailing Address
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Address Line | PO BOX 2219
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City | PEMBROKE
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State | NC
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Zip | 28372-2219
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Country | US
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Telephone | 910-521-3093
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Fax | 910-521-3095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2915
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License Number State | NC
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