Provider Demographics
NPI:1508207374
Name:JENNINGS, STEVEN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PATRICK
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-2966
Mailing Address - Country:US
Mailing Address - Phone:414-488-2087
Mailing Address - Fax:414-488-2102
Practice Address - Street 1:114 E GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-2966
Practice Address - Country:US
Practice Address - Phone:414-488-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4934-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor