Provider Demographics
NPI:1730113093
Name:MCCURDY, JENNIFER J (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:MCCURDY
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 1:200 N HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2512
Mailing Address - Country:US
Mailing Address - Phone:515-961-9800
Mailing Address - Fax:
Practice Address - Street 1:200 N HOWARD ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2512
Practice Address - Country:US
Practice Address - Phone:515-961-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0468645Medicaid
IAI14264Medicare ID - Type Unspecified
U89755Medicare UPIN