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Individual
MR. JEFFREY RUSSELL DEXTER
Active
Individual
MR. JEFFREY RUSSELL DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1730
OH
111N00000X
Chiropractor
762
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000120157
ANTHEM
—
05
—
0459294
—
OH
Enumeration date
12/27/2005
Last updated
06/17/2013
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