Jennifer Marie Vine, D.C.
Individual provider Active NPI Pediatric Chiropractor · Hancock, MN
NPI 1083159131 · NPPES record last updated Nov 23, 2021
Key facts
- NPI
- 1083159131
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Chiropractor 111NP0017X
- License
- 6721 (MN)
- Practice address
- 657 Atlantic Ave
Hancock, MN 56244-2104 - Phone
- (320) 349-1650
- NPI assigned
- Dec 28, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHI-CHI-LIC-4515 | MT | MD | Chiropractor |
| 4515 | MT | MD | Pediatric Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Design Chiropractic, PLLC | Chiropractor | Current |
Accepting new patients |
| Morrell Spine & Sport | Chiropractor | Past |
Accepting new patients |
| Tru Chiropractic | Chiropractor | Past |
Accepting new patients |
Locations
222 E Main St
Unit 1C
Ennis, MT 59729
Phone (406) 946-1813
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6721 | MN | |
| Chiropractor | 111N00000X | CHI-CHI-LIC-4515 | MT | |
| Pediatric Chiropractor | 111NP0017X | 4515 | MT | |
| Pediatric Chiropractor | 111NP0017X | 6721 | MN | Yes |
Addresses
Primary practice location
657 Atlantic Ave
Hancock, MN 56244-2104
Mailing address
39041 County Road 2
Hancock, MN 56244-1215
Phone (320) 349-1650
Other names
- Jennifer Marie Noordmans
Other providers in Hancock, MN
- Hancock Dental Clinic, PA
- Bridget Ilene Joos
- Julia'S Place
- Life Design Chiropractic LLC
- Stevens County Ind School Dist 768
All providers in Hancock, MN · Pediatric Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.