Individual
DR. JACK ROBERT MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., FNP-BC
Contact information
Practice address
4439 STATE ROUTE 159 STE 280, CHILLICOTHE, OH 45601-7502
(740) 779-7050
Mailing address
4439 STATE ROUTE 159 STE 280, CHILLICOTHE, OH 45601-7502
(740) 779-7050
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3416
OH
111N00000X
Chiropractor
4768
KY
111N00000X
Chiropractor
971
WV
363L00000X
Nurse Practitioner
Primary
14318
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA.14318-NP
STATE OF OHIO LICENSE
OH
Enumeration date
07/18/2005
Last updated
12/28/2020
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