Provider Demographics
NPI:1619037439
Name:PERSON, JENNIFER ANN (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:PERSON
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 1:653 PILLSBURY ST N
Mailing Address - Street 2:
Mailing Address - City:PILLAGER
Mailing Address - State:MN
Mailing Address - Zip Code:56473-2543
Mailing Address - Country:US
Mailing Address - Phone:218-746-4550
Mailing Address - Fax:218-898-7595
Practice Address - Street 1:653 PILLSBURY ST N
Practice Address - Street 2:
Practice Address - City:PILLAGER
Practice Address - State:MN
Practice Address - Zip Code:56473-2543
Practice Address - Country:US
Practice Address - Phone:218-746-4550
Practice Address - Fax:218-898-7595
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor