Provider Demographics
NPI:1962551689
Name:BETT-GRAY, JENNIFER L (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BETT-GRAY
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 1:136 WILSON PIKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5280
Mailing Address - Country:US
Mailing Address - Phone:615-373-7009
Mailing Address - Fax:615-373-7090
Practice Address - Street 1:136 WILSON PIKE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5280
Practice Address - Country:US
Practice Address - Phone:615-373-7009
Practice Address - Fax:615-373-7090
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4079900OtherBCBS
TN9129290OtherPHCS
TN2631190OtherCIGNA
TN622740OtherUNITED HEALTHCARE
TN3970671OtherMEDICARE PTIN
TN4079900OtherBCBS