Provider Demographics
NPI:1184028003
Name:DAVIS, JENNIFER DAWN (D C)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DAWN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1212 BENT OAKS CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8061
Mailing Address - Country:US
Mailing Address - Phone:940-243-0108
Mailing Address - Fax:940-387-3446
Practice Address - Street 1:1212 BENT OAKS CT
Practice Address - Street 2:SUITE 200
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8061
Practice Address - Country:US
Practice Address - Phone:940-243-0108
Practice Address - Fax:940-387-3446
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor