Provider Demographics
NPI:1760443055
Name:BERNICK, JENNIFER LYNN (DC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:BERNICK
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:GERHARDSON CHIROPRACTIC
Mailing Address - Street 2:3333 W. DIVISION ST SUITE 122A
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301
Mailing Address - Country:US
Mailing Address - Phone:320-420-1204
Mailing Address - Fax:320-281-5243
Practice Address - Street 1:GERHARDSON CHIROPRACTIC
Practice Address - Street 2:3333 W. DIVISION ST SUITE 122A
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301
Practice Address - Country:US
Practice Address - Phone:320-420-1204
Practice Address - Fax:320-281-5243
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN4664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor