Provider Demographics
NPI:1740510791
Name:HILLMAN, JENNA DEEANNE HARDIN (DC)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:DEEANNE HARDIN
Last Name:HILLMAN
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 1:8302 INDIANA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2835
Mailing Address - Country:US
Mailing Address - Phone:806-368-6037
Mailing Address - Fax:806-368-6087
Practice Address - Street 1:8302 INDIANA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2835
Practice Address - Country:US
Practice Address - Phone:806-368-6037
Practice Address - Fax:806-368-6087
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor