Stephen Layne Jennings, D.C.
Individual provider Active NPI Chiropractor · Rensselaer, IN
NPI 1669528261 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669528261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08000578A (IN)
- Practice address
- 101 N Austin Ave
Rensselaer, IN 47978-2657 - Phone
- (219) 866-7164
- Fax
- (219) 866-0515
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08000578A | IN | Yes |
Addresses
Primary practice location
101 N Austin Ave
Rensselaer, IN 47978-2657
Mailing address
101 N Austin Ave
Rensselaer, IN 47978-2657
Phone (219) 866-7164
Other providers in Rensselaer, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.