Provider Demographics
NPI:1396071874
Name:PHILLIPS, JENNIFER (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:556 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-3246
Mailing Address - Country:US
Mailing Address - Phone:603-224-4281
Mailing Address - Fax:603-224-4281
Practice Address - Street 1:556 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-3246
Practice Address - Country:US
Practice Address - Phone:603-224-4281
Practice Address - Fax:603-224-4281
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH795-0807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor