Individual
DR. JEFF W LISSENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1320 SE MAYNARD RD, SUITE 102, CARY, NC 27511
(919) 650-2700
(919) 650-1267
Mailing address
1320 SE MAYNARD RD, SUITE 102, CARY, NC 27511
(919) 650-2700
(919) 650-1267
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1894
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085XH
BLUE CROSS BLUE SHIELD
NC
01
—
609865
ACN
NC
Enumeration date
08/17/2006
Last updated
11/25/2024
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