Provider Demographics
NPI:1972657716
Name:HIRZEL, JENNIFER JOI (DC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOI
Last Name:HIRZEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JOI
Other - Last Name:KLEPPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:13528 OLD 41 RD
Mailing Address - Street 2:
Mailing Address - City:KEWEENAW BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49908-9022
Mailing Address - Country:US
Mailing Address - Phone:906-353-7588
Mailing Address - Fax:
Practice Address - Street 1:13528 OLD 41 RD
Practice Address - Street 2:
Practice Address - City:KEWEENAW BAY
Practice Address - State:MI
Practice Address - Zip Code:49908-9022
Practice Address - Country:US
Practice Address - Phone:906-353-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950Z750010OtherBCBS
MI950Z750010OtherBCBS