Provider Demographics
NPI:1053575308
Name:BEMIS, JILL M (DC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:BEMIS
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 1:124 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1808
Mailing Address - Country:US
Mailing Address - Phone:541-948-9988
Mailing Address - Fax:866-411-9336
Practice Address - Street 1:124 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1808
Practice Address - Country:US
Practice Address - Phone:541-948-9988
Practice Address - Fax:866-411-9336
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor