Provider Demographics
NPI:1801159173
Name:SADOCK, JENNIFER B (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:B
Last Name:SADOCK
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 1:2307 W CONE BLVD STE 182
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4051
Mailing Address - Country:US
Mailing Address - Phone:336-404-7734
Mailing Address - Fax:
Practice Address - Street 1:2307 W CONE BLVD STE 182
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4051
Practice Address - Country:US
Practice Address - Phone:336-404-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor