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NPI Code Detail

MEDICARE: DR. JENESSA VANSANDT DC, CCEP

MEDICARE: DR. JENESSA VANSANDT DC, CCEP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHR.0007518CO

General Provider Information

NPI Number : 1578004313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENESSA VANSANDT DC, CCEP
Provider Business Mailing Address
First Line : 2601 S LEMAY AVE STE 35
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-2296
Country : US
Telephone Number : 970-685-8249
Fax Number :
Provider Business Practice Location Address
First Line : 2601 S LEMAY AVE STE 35
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-2296
Country : US
Telephone Number : 970-685-8249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2017
Last Update Date : 10/24/2023

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