Healthcare Provider Details

I. General information

NPI: 1558485193
Provider Name (Legal Business Name): JENNIFER LYNN WESTCOTT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29701 SIX MILE RD STE 150A
LIVONIA MI
48152
US

IV. Provider business mailing address

29671 6 MILE RD STE 110C
LIVONIA MI
48152-4555
US

V. Phone/Fax

Practice location:
  • Phone: 734-427-1579
  • Fax: 734-427-0976
Mailing address:
  • Phone: 734-427-1579
  • Fax: 734-427-0976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberJW007223
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: