Provider Demographics
NPI:1225466022
Name:JAMROG, JENNIFER J (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:JAMROG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WINDWARD WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3385
Mailing Address - Country:US
Mailing Address - Phone:406-756-8488
Mailing Address - Fax:
Practice Address - Street 1:245 WINDWARD WAY STE 101
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3385
Practice Address - Country:US
Practice Address - Phone:406-756-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7895204D00000X
390200000X
MT57509204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program