Provider Demographics
NPI:1912380247
Name:COTONE, JENNIFER L (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:COTONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:GODBOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:169 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:READFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04355-3340
Mailing Address - Country:US
Mailing Address - Phone:207-620-2078
Mailing Address - Fax:
Practice Address - Street 1:169 SOUTH RD
Practice Address - Street 2:
Practice Address - City:READFIELD
Practice Address - State:ME
Practice Address - Zip Code:04355-3340
Practice Address - Country:US
Practice Address - Phone:207-620-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR2308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor