Provider Demographics
NPI:1588704878
Name:PEELOR, JEAN E (DC)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:E
Last Name:PEELOR
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 1:549 AMERICAN LEGION HWY UNIT 1
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4129
Mailing Address - Country:US
Mailing Address - Phone:774-309-3555
Mailing Address - Fax:743-093-5567
Practice Address - Street 1:549 AMERICAN LEGION HWY UNIT 1
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4129
Practice Address - Country:US
Practice Address - Phone:774-309-3555
Practice Address - Fax:774-309-3556
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA749OtherLICENSE
208253910OtherFEDERAL TAX
MAY35534OtherPROVIDER