Individual
MR. JEFFREY RUSSELL DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
325 4TH ST, MARIETTA, OH 45750-2002
(740) 376-9944
(740) 376-0094
Mailing address
325 4TH ST, MARIETTA, OH 45750-2002
(740) 376-9944
(740) 376-0094
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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