Provider Demographics
NPI:1275778201
Name:VERO, JODIE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JODIE
Middle Name:LYNN
Last Name:VERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JODIE
Other - Middle Name:LYNN
Other - Last Name:DOEBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:330 HANSEN PLZ
Mailing Address - Street 2:
Mailing Address - City:LYNDORA
Mailing Address - State:PA
Mailing Address - Zip Code:16045-1610
Mailing Address - Country:US
Mailing Address - Phone:724-256-8600
Mailing Address - Fax:724-256-8622
Practice Address - Street 1:330 HANSEN PLZ
Practice Address - Street 2:
Practice Address - City:LYNDORA
Practice Address - State:PA
Practice Address - Zip Code:16045-1610
Practice Address - Country:US
Practice Address - Phone:724-256-8600
Practice Address - Fax:724-256-8622
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor