Healthcare Provider Details

I. General information

NPI: 1669815692
Provider Name (Legal Business Name): JENNIFER CHARESE REED D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W DIMOND BLVD SUITE 4
ANCHORAGE AK
99502-1475
US

IV. Provider business mailing address

403 OVERLAND AVE STE A
KENAI AK
99611-8050
US

V. Phone/Fax

Practice location:
  • Phone: 907-243-0660
  • Fax: 907-248-5481
Mailing address:
  • Phone: 907-395-4466
  • Fax: 907-395-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12347
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number605
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: