Provider Demographics
NPI:1720397136
Name:GETTYS, JENNIE MARIE (DC)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:MARIE
Last Name:GETTYS
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 1:714 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-5514
Mailing Address - Country:US
Mailing Address - Phone:864-271-4240
Mailing Address - Fax:
Practice Address - Street 1:714 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-5514
Practice Address - Country:US
Practice Address - Phone:864-271-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-03
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor