Provider Demographics
NPI:1477595221
Name:KANE, JENNIFER CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:KANE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1292 STILL HOUSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1956
Mailing Address - Country:US
Mailing Address - Phone:314-496-8044
Mailing Address - Fax:
Practice Address - Street 1:300 OZARK TRAIL DR STE 105
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2156
Practice Address - Country:US
Practice Address - Phone:636-207-6600
Practice Address - Fax:636-207-6631
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001011188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053515957OtherNPI