Provider Demographics
NPI:1619201340
Name:BISCHOFF, JENNIFER ANN (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:BISCHOFF
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 1:8380 CITY CENTRE DR
Mailing Address - Street 2:STE 180
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-5304
Mailing Address - Country:US
Mailing Address - Phone:612-275-6110
Mailing Address - Fax:
Practice Address - Street 1:8380 CITY CENTRE DR
Practice Address - Street 2:STE 180
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-5304
Practice Address - Country:US
Practice Address - Phone:612-275-6110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4480-12111N00000X
MN5277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor