Healthcare Provider Details

I. General information

NPI: 1710396551
Provider Name (Legal Business Name): JENNIFER LAUREN HEPLER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S YONGE ST STE 13A
ORMOND BEACH FL
32174-7588
US

IV. Provider business mailing address

319 TIMBERLINE TRL
ORMOND BEACH FL
32174-8505
US

V. Phone/Fax

Practice location:
  • Phone: 386-232-8114
  • Fax:
Mailing address:
  • Phone: 386-295-8490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 11278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: