Individual
DR. DEAN C JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1550 JOHN SIMS PKWY E, NICEVILLE, FL 32578-2138
(850) 678-8048
(855) 333-8662
Mailing address
1550 JOHN SIMS PKWY E, NICEVILLE, FL 32578-2138
(850) 678-8048
(855) 333-8662
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0007168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350046350
RAILROAD MEDICARE
FL
01
—
55486
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/19/2006
Last updated
10/16/2015
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