Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 16006 | AR |
NPI | 1487992566 |
---|---|
Provider Name | Dr. Kelly Jennings |
First Address | Hot Springs, AR 71902-0645 |
Second Address | Hot Springs, AR 71901-6443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2013 |
Last Update Date | 20/08/2013 |