Provider Demographics
NPI:1194263137
Name:ESSENBURG, JENNA (DC, ATC)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:
Last Name:ESSENBURG
Suffix:
Gender:
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13761 HARRINGTON LNDG
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-7485
Mailing Address - Country:US
Mailing Address - Phone:616-510-6805
Mailing Address - Fax:
Practice Address - Street 1:3360 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-1420
Practice Address - Country:US
Practice Address - Phone:616-669-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
MI2301401384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer