Provider Demographics
NPI:1427640903
Name:ARMISTEAD, JENNIFER (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ARMISTEAD
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 1:2197 LAKE PARK DR SE APT C
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8965
Mailing Address - Country:US
Mailing Address - Phone:845-629-5656
Mailing Address - Fax:
Practice Address - Street 1:60 WHITLOCK PL SW STE A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3172
Practice Address - Country:US
Practice Address - Phone:770-726-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor