Provider Demographics
NPI:1952301467
Name:JONES, DENISE LYNN (DC)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:LYNN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 S LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:54669-1620
Mailing Address - Country:US
Mailing Address - Phone:608-786-1426
Mailing Address - Fax:608-786-0000
Practice Address - Street 1:149 S LEONARD ST
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-1620
Practice Address - Country:US
Practice Address - Phone:608-786-1426
Practice Address - Fax:608-786-0000
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI364557851001OtherBC/BS
WI35644Medicare ID - Type Unspecified
U73593Medicare UPIN