Provider Demographics
NPI:1528330321
Name:LANCE, JENNIFER ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:LANCE
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 1:880 LAWRENCE RD # 180
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2707
Mailing Address - Country:US
Mailing Address - Phone:281-334-0100
Mailing Address - Fax:281-334-0108
Practice Address - Street 1:880 LAWRENCE RD # 180
Practice Address - Street 2:
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-2707
Practice Address - Country:US
Practice Address - Phone:281-334-0100
Practice Address - Fax:281-334-0108
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor