Provider Demographics
NPI:1003093089
Name:CONNORS, JENNIFER MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:CONNORS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 659
Mailing Address - Street 2:
Mailing Address - City:FISKDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01518-0659
Mailing Address - Country:US
Mailing Address - Phone:508-347-3834
Mailing Address - Fax:
Practice Address - Street 1:464 MAIN ST
Practice Address - Street 2:
Practice Address - City:FISKDALE
Practice Address - State:MA
Practice Address - Zip Code:01518-1290
Practice Address - Country:US
Practice Address - Phone:508-347-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45023Medicare UPIN