Healthcare Provider Details

I. General information

NPI: 1669750980
Provider Name (Legal Business Name): JENETTE STOVER AUCHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 DOGWOOD TRL STE B
DEBARY FL
32713-2443
US

IV. Provider business mailing address

10 DOGWOOD TRL STE B
DEBARY FL
32713-2443
US

V. Phone/Fax

Practice location:
  • Phone: 386-320-0325
  • Fax: 386-320-0318
Mailing address:
  • Phone: 386-320-0325
  • Fax: 386-320-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number10270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: