Healthcare Provider Details

I. General information

NPI: 1598236143
Provider Name (Legal Business Name): JENNIFER SYKES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 DURAND AVE STE 415
RACINE WI
53405-4458
US

IV. Provider business mailing address

3701 DURAND AVE STE 415
RACINE WI
53405-4458
US

V. Phone/Fax

Practice location:
  • Phone: 545-826-2554
  • Fax:
Mailing address:
  • Phone: 545-826-2554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5415-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: