Provider Demographics
NPI:1588413868
Name:FOX, JENNIFER (DAC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 KRUGER ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5166
Mailing Address - Country:US
Mailing Address - Phone:304-830-2937
Mailing Address - Fax:
Practice Address - Street 1:242 KRUGER ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5166
Practice Address - Country:US
Practice Address - Phone:304-830-2937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist