Provider Demographics
NPI:1902033293
Name:SELTZER-OGLE, JENNIFER ANNA (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNA
Last Name:SELTZER-OGLE
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 1:24517 RUTHERFORD RD
Mailing Address - Street 2:
Mailing Address - City:RAMONA
Mailing Address - State:CA
Mailing Address - Zip Code:92065-4029
Mailing Address - Country:US
Mailing Address - Phone:858-699-1199
Mailing Address - Fax:
Practice Address - Street 1:590 LAGUNA DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1607
Practice Address - Country:US
Practice Address - Phone:760-434-6141
Practice Address - Fax:760-434-5161
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19980111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation