Provider Demographics
NPI:1699076059
Name:MCCARTNEY, JENNIFER MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:MCCARTNEY
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 1:3302 CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2446
Mailing Address - Country:US
Mailing Address - Phone:248-629-6071
Mailing Address - Fax:248-629-6073
Practice Address - Street 1:3302 CROOKS RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-2446
Practice Address - Country:US
Practice Address - Phone:248-629-6071
Practice Address - Fax:248-629-6073
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor