Provider Demographics
NPI:1598002156
Name:ANTHOFER, JENNA JOY (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:JOY
Last Name:ANTHOFER
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 1:1205 W US HWY 30
Mailing Address - Street 2:STE E
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-3364
Mailing Address - Country:US
Mailing Address - Phone:712-792-4600
Mailing Address - Fax:712-792-7775
Practice Address - Street 1:1205 W US HWY 30
Practice Address - Street 2:STE E
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-3364
Practice Address - Country:US
Practice Address - Phone:712-792-4600
Practice Address - Fax:712-792-7775
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5721111N00000X
IA7698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor