Provider Demographics
NPI:1598191447
Name:DEPICE, JENNIFER JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JEAN
Last Name:DEPICE
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 1:910 YORK RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2128
Mailing Address - Country:US
Mailing Address - Phone:215-657-1701
Mailing Address - Fax:215-657-9695
Practice Address - Street 1:907 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2051
Practice Address - Country:US
Practice Address - Phone:215-657-1701
Practice Address - Fax:215-657-9695
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003871111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor