Provider Demographics
NPI:1396237814
Name:MOHRBECK, JESSICA CAROL (DC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:CAROL
Last Name:MOHRBECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 LONG PRAIRIE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2775
Mailing Address - Country:US
Mailing Address - Phone:214-436-0827
Mailing Address - Fax:
Practice Address - Street 1:3305 LONG PRAIRIE RD STE 120
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2775
Practice Address - Country:US
Practice Address - Phone:214-436-0827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor