Provider Demographics
NPI:1962723304
Name:DAVIS, JENNIFER L (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:4061 POWDER MILL ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CALVERTON
Mailing Address - State:MD
Mailing Address - Zip Code:20705
Mailing Address - Country:US
Mailing Address - Phone:301-444-4890
Mailing Address - Fax:301-444-4893
Practice Address - Street 1:4641 MONTGOMERY AVE STE 404
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3431
Practice Address - Country:US
Practice Address - Phone:240-670-0081
Practice Address - Fax:240-858-6197
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2019-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD03621111NR0400X
MDS03621111NR0400X
VA0104556804111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation