Provider Demographics
NPI:1528251980
Name:RUNYAN, JENNIFER R (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:RUNYAN
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 1:1003 OAKHURST DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2044
Mailing Address - Country:US
Mailing Address - Phone:304-720-7777
Mailing Address - Fax:304-720-7779
Practice Address - Street 1:1003 OAKHURST DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-2044
Practice Address - Country:US
Practice Address - Phone:304-720-7777
Practice Address - Fax:304-720-7779
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor