Provider Demographics
NPI:1003105453
Name:STEPANEK, JENNIFER CARMELL (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CARMELL
Last Name:STEPANEK
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 1:2006 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2430
Mailing Address - Country:US
Mailing Address - Phone:772-778-2225
Mailing Address - Fax:
Practice Address - Street 1:2006 32ND AVE
Practice Address - Street 2:STE A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2430
Practice Address - Country:US
Practice Address - Phone:772-778-2225
Practice Address - Fax:772-778-0304
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor