Provider Demographics
NPI:1740327261
Name:STOWASSER, JENNIFER LEE (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEE
Last Name:STOWASSER
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 1:2441 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1684
Mailing Address - Country:US
Mailing Address - Phone:805-934-5703
Mailing Address - Fax:805-934-1590
Practice Address - Street 1:2441 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1684
Practice Address - Country:US
Practice Address - Phone:805-934-5703
Practice Address - Fax:805-934-1590
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor