Provider Demographics
NPI:1316918105
Name:FEATHERSTON, JEFFREY T (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:T
Last Name:FEATHERSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27527 JOY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5503
Mailing Address - Country:US
Mailing Address - Phone:734-522-5501
Mailing Address - Fax:734-522-0339
Practice Address - Street 1:27527 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5503
Practice Address - Country:US
Practice Address - Phone:734-522-5501
Practice Address - Fax:734-522-0339
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950H220980OtherBLUE CROSS
MION57460Medicare ID - Type Unspecified004