Healthcare Provider Details

I. General information

NPI: 1134261597
Provider Name (Legal Business Name): JENNIFER ANDREA LOUREY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 IVY AVE SE
RICHMOND MN
56368-4509
US

IV. Provider business mailing address

307 IVY AVE SE
RICHMOND MN
56368-4509
US

V. Phone/Fax

Practice location:
  • Phone: 320-597-8999
  • Fax: 320-597-8995
Mailing address:
  • Phone: 320-321-0166
  • Fax: 320-321-0167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number299
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number003166
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: