Provider Demographics
NPI:1104865310
Name:KIM, JENNY REBECCA (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:REBECCA
Last Name:KIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNY
Other - Middle Name:REBECCA
Other - Last Name:SCHEITEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:522 BELL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2002
Mailing Address - Country:US
Mailing Address - Phone:615-360-3000
Mailing Address - Fax:615-360-2036
Practice Address - Street 1:615 BAKERS BRIDGE AVENUE
Practice Address - Street 2:SUITE 120
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-764-0001
Practice Address - Fax:615-764-0002
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor