Provider Demographics
NPI:1033282330
Name:ENGESETHER, JENNIFER LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:ENGESETHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1650 W 82ND ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1419
Mailing Address - Country:US
Mailing Address - Phone:952-844-0844
Mailing Address - Fax:952-844-0810
Practice Address - Street 1:1650 W 82ND ST
Practice Address - Street 2:SUITE 800
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1419
Practice Address - Country:US
Practice Address - Phone:952-844-0844
Practice Address - Fax:952-844-0810
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor