Provider Demographics
NPI:1427730167
Name:CHAREECE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CHAREECE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JESKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-322-7542
Mailing Address - Street 1:2620 MEMORIAL BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-1488
Mailing Address - Country:US
Mailing Address - Phone:724-322-7542
Mailing Address - Fax:
Practice Address - Street 1:2620 MEMORIAL BLVD STE E
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1488
Practice Address - Country:US
Practice Address - Phone:724-322-7542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty