Provider Demographics
NPI:1013249457
Name:BORBIDGE, JENNA (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:
Last Name:BORBIDGE
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 1:783 ROUTE 3A
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-4007
Mailing Address - Country:US
Mailing Address - Phone:603-856-7790
Mailing Address - Fax:603-856-7894
Practice Address - Street 1:783 ROUTE 3A
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4007
Practice Address - Country:US
Practice Address - Phone:603-856-7790
Practice Address - Fax:603-856-7894
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH883111N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3105960Medicaid