Provider Demographics
NPI:1548475056
Name:PITTENGER, JEFFREY B (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:PITTENGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15502 STONEYBROOK WEST PKWY
Mailing Address - Street 2:STE 104-304
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4767
Mailing Address - Country:US
Mailing Address - Phone:407-982-7747
Mailing Address - Fax:
Practice Address - Street 1:16112 MARSH RD
Practice Address - Street 2:STE 416
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-9195
Practice Address - Country:US
Practice Address - Phone:407-982-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor