Healthcare Provider Details

I. General information

NPI: 1528081262
Provider Name (Legal Business Name): JENNIFER LYNN VANWINKLE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2963 W DICKMAN RD
SPRINGFIELD MI
49037-7939
US

IV. Provider business mailing address

10507 S MACKINAC TRL
DAFTER MI
49724-9550
US

V. Phone/Fax

Practice location:
  • Phone: 269-223-7870
  • Fax: 269-223-7871
Mailing address:
  • Phone: 269-986-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberJV007322
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: