Provider Demographics
NPI:1669704425
Name:HIGHTOWER, JENNIFER ELLYN (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELLYN
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:ELLYN
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:502 THE PKWY
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-2271
Mailing Address - Country:US
Mailing Address - Phone:585-739-3826
Mailing Address - Fax:
Practice Address - Street 1:502 THE PKWY
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-2271
Practice Address - Country:US
Practice Address - Phone:585-739-3826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor