Provider Demographics
NPI:1811198260
Name:BROOKS, JENNIFER ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:BROOKS
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 1:252 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1422
Mailing Address - Country:US
Mailing Address - Phone:859-554-5844
Mailing Address - Fax:866-907-9419
Practice Address - Street 1:252 E HIGH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1422
Practice Address - Country:US
Practice Address - Phone:859-554-5844
Practice Address - Fax:866-907-9419
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4603111N00000X
MI2301009988111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor