Provider Demographics
NPI:1942898267
Name:EDWARDS, JAYLEE KRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAYLEE
Middle Name:KRISTINE
Last Name:EDWARDS
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 1:11570 BERRY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-1899
Mailing Address - Country:US
Mailing Address - Phone:940-230-4709
Mailing Address - Fax:
Practice Address - Street 1:2214 EMERY ST # 510
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1101
Practice Address - Country:US
Practice Address - Phone:940-208-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor