Healthcare Provider Details
I. General information
NPI: 1891129383
Provider Name (Legal Business Name): JACINDA LEIGH HOVER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/03/2013
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 LINDSLEY DRIVE 201
MORRISTOWN NJ
07960-4455
US
IV. Provider business mailing address
25 LINDSLEY DR STE 201
MORRISTOWN NJ
07960-4456
US
V. Phone/Fax
- Phone: 973-828-8010
- Fax:
- Phone: 973-828-8010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | X012387-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 38MC00710600 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: