Provider Demographics
NPI:1518496488
Name:JENNINGS, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-1108
Mailing Address - Country:US
Mailing Address - Phone:816-656-1535
Mailing Address - Fax:855-276-2178
Practice Address - Street 1:900 W 17TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-1108
Practice Address - Country:US
Practice Address - Phone:816-656-1535
Practice Address - Fax:855-276-2178
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016022435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor