Healthcare Provider Details

I. General information

NPI: 1518010115
Provider Name (Legal Business Name): JODY DANETTE CONFER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 MINNOW LANE
STILLWATER PA
17878-9433
US

IV. Provider business mailing address

9 MINNOW LANE
STILLWATER PA
17878-9433
US

V. Phone/Fax

Practice location:
  • Phone: 570-925-2329
  • Fax: 570-925-2329
Mailing address:
  • Phone: 570-925-2329
  • Fax: 570-925-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003002L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: