Provider Demographics
NPI:1073301842
Name:BRILEY, JESSICA (DC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BRILEY
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 MONCREIFFE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7814
Mailing Address - Country:US
Mailing Address - Phone:984-219-2860
Mailing Address - Fax:984-222-7118
Practice Address - Street 1:10310 MONCREIFFE RD STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7814
Practice Address - Country:US
Practice Address - Phone:984-219-2860
Practice Address - Fax:984-222-7118
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor