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NPI Code Detail

MEDICARE: DR. JESSICA GUNDELFINGER D.C.

MEDICARE: DR. JESSICA GUNDELFINGER 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
1111N00000XChiropractor558AK
2111N00000XChiropractor4506NC

General Provider Information

NPI Number : 1255767323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA GUNDELFINGER D.C.
Provider Business Mailing Address
First Line : 34 OLEANDER DR STE 104
Second Line :
City : CLAYTON
State : NC
Zip : 27527-4599
Country : US
Telephone Number : 919-585-1313
Fax Number : 919-585-1350
Provider Business Practice Location Address
First Line : 34 OLEANDER DR STE 104
Second Line :
City : CLAYTON
State : NC
Zip : 27527-4599
Country : US
Telephone Number : 919-585-1313
Fax Number : 919-585-1350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2013
Last Update Date : 08/21/2014

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