Healthcare Provider Details

I. General information

NPI: 1104865310
Provider Name (Legal Business Name): JENNY REBECCA KIM DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNY REBECCA SCHEITEL-KIM DC

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 TROTWOOD AVE STE 14
COLUMBIA TN
38401-4979
US

IV. Provider business mailing address

1412 TROTWOOD AVE STE 14
COLUMBIA TN
38401-4979
US

V. Phone/Fax

Practice location:
  • Phone: 615-428-6916
  • Fax:
Mailing address:
  • Phone: 931-388-6437
  • Fax: 931-540-8763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2039
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: