Provider Demographics
NPI:1699912774
Name:POSEY, JEROD ANTHONY
Entity type:Individual
Prefix:DR
First Name:JEROD
Middle Name:ANTHONY
Last Name:POSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16753 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1231
Mailing Address - Country:US
Mailing Address - Phone:618-946-0975
Mailing Address - Fax:
Practice Address - Street 1:16753 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1231
Practice Address - Country:US
Practice Address - Phone:618-946-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000018111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography