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General NPI Number Information
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NPI Number | 1548333537
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Entity Type | Individual
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Provider Name | JENNIFER RIDLEY DC
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 749 LONESOME DOVE TRL
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City | HURST
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State | TX
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Zip | 76054-6018
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Country | US
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Telephone | 817-683-2256
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Fax |
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Provider Business Mailing Address
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Address Line | 2012 EDGEBROOK CT
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City | ARLINGTON
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State | TX
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Zip | 76015-4000
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Country | US
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Telephone | 817-683-2256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10449
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License Number State | TX
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