Provider Demographics
NPI:1609899442
Name:MITCHEL, JENNIFER LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEIGH
Last Name:MITCHEL
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 1:555 TRENTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1494
Mailing Address - Country:US
Mailing Address - Phone:720-251-5590
Mailing Address - Fax:315-748-5319
Practice Address - Street 1:555 TRENTON DR
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1494
Practice Address - Country:US
Practice Address - Phone:720-251-5590
Practice Address - Fax:315-748-5319
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557690111N00000X
CO5802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor