Provider Demographics
NPI:1225186562
Name:BODENSTEINER, JILL MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MARIE
Last Name:BODENSTEINER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:521 S SAINT VRAIN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-0018
Mailing Address - Country:US
Mailing Address - Phone:970-577-0007
Mailing Address - Fax:
Practice Address - Street 1:521 S SAINT VRAIN AVE UNIT B
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-0018
Practice Address - Country:US
Practice Address - Phone:970-577-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor