Provider Demographics
NPI:1790880029
Name:NOWAK, JENNIFER FRANCES (DC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FRANCES
Last Name:NOWAK
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 1:1219 COUNTY LINE ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-6001
Mailing Address - Country:US
Mailing Address - Phone:614-425-3986
Mailing Address - Fax:614-423-7068
Practice Address - Street 1:1219 COUNTY LINE ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6001
Practice Address - Country:US
Practice Address - Phone:614-425-3986
Practice Address - Fax:614-423-7068
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIR4135851Medicare ID - Type Unspecified
V00293Medicare UPIN