Provider Demographics
NPI:1558102459
Name:SELSER, JESSE (DC)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:SELSER
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 1:2850 MANHATTAN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2911
Mailing Address - Country:US
Mailing Address - Phone:504-362-3000
Mailing Address - Fax:504-362-3059
Practice Address - Street 1:2850 MANHATTAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2911
Practice Address - Country:US
Practice Address - Phone:504-362-3000
Practice Address - Fax:504-362-3059
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1642111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation