Jezioro, John Richard
Jezioro, John Richard is an sole proprietor health care provider with primary practice located at 1565 Fairmont Ave , Fairmont WV 26554-2158. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Jezioro, John Richard can be contacted via phone (304) 363-8890.Contact Information
Primary practice address
1565 Fairmont Ave
Fairmont WV 26554-2158
Phone: (304) 363-8890
Fax: (304) 363-8902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 660 | West Virginia |
Profile Details
| NPI number | 1871669614 |
|---|---|
| LBN Legal business name | Jezioro, John Richard |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 24th, 2006 |
| Last updated | Nov 29th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871669614 | NPPES |
| West Virginia | Other | 000342746 | BCBS |
| West Virginia | MEDICAID | 7600047000 | BCBS |
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