Provider Demographics
NPI:1528244266
Name:MCCOMB, JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:MCCOMB
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 1:1964 RAHNCLIFF CT
Mailing Address - Street 2:STE 100
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1964 RAHNCLIFF CT
Practice Address - Street 2:STE 100
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3421
Practice Address - Country:US
Practice Address - Phone:952-432-3833
Practice Address - Fax:952-432-7706
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor