Provider Demographics
NPI:1467285213
Name:WALKER, JESSE RAYMOND (DC)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:RAYMOND
Last Name:WALKER
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 1:1113 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-7637
Mailing Address - Country:US
Mailing Address - Phone:937-393-9609
Mailing Address - Fax:937-393-9606
Practice Address - Street 1:1113 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-7637
Practice Address - Country:US
Practice Address - Phone:937-393-9609
Practice Address - Fax:937-393-9606
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor