Provider Demographics
NPI:1619387602
Name:JENNIFER M RAYBURN, P.C.
Entity Type:Organization
Organization Name:JENNIFER M RAYBURN, P.C.
Other - Org Name:HEALING HANDS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAYBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-236-0309
Mailing Address - Street 1:615 HORSESHOE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-4711
Mailing Address - Country:US
Mailing Address - Phone:641-236-0309
Mailing Address - Fax:641-236-0183
Practice Address - Street 1:615 HORSESHOE DR
Practice Address - Street 2:SUITE F
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-4711
Practice Address - Country:US
Practice Address - Phone:641-236-0309
Practice Address - Fax:641-236-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty