Provider Demographics
NPI:1447410576
Name:BRATT, JENNIFER LEE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:BRATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2796 HEIDLERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7617
Mailing Address - Country:US
Mailing Address - Phone:717-614-5079
Mailing Address - Fax:
Practice Address - Street 1:2796 HEIDLERSBURG RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7617
Practice Address - Country:US
Practice Address - Phone:717-614-5079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor