Provider Demographics
NPI:1174672133
Name:SELLERS, JEANNE M (DC)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:M
Last Name:SELLERS
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 1:5837 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-5042
Mailing Address - Country:US
Mailing Address - Phone:813-885-5786
Mailing Address - Fax:813-886-0559
Practice Address - Street 1:5837 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-5042
Practice Address - Country:US
Practice Address - Phone:813-885-5786
Practice Address - Fax:813-886-0559
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88571Medicare ID - Type Unspecified