Individual
JESSE EASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2110 FORDEM AVE, MADISON, WI 53704-4610
(608) 244-7447
Mailing address
2110 FORDEM AVE, MADISON, WI 53704-4610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5218-12
WI
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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