Provider Demographics
NPI:1003884115
Name:BARNES, JENNIFER HEBERLE (DC,)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HEBERLE
Last Name:BARNES
Suffix:
Gender:F
Credentials:DC,
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LYN
Other - Last Name:HEBERLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:243 CENTER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-2101
Mailing Address - Country:US
Mailing Address - Phone:585-394-3420
Mailing Address - Fax:585-394-3675
Practice Address - Street 1:243 CENTER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-2101
Practice Address - Country:US
Practice Address - Phone:585-394-3420
Practice Address - Fax:585-394-3675
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007509-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY109889ANOtherPREFERRED CARE
NY5537039OtherAETNA
NYP010007509OtherEXCELLUS