=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922122068
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER MAUREEN MERCER DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2007
-----------------------------------------------------
Last Update Date | 04/23/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 E 9TH ST STE. F
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64683-2763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 660-339-7888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1601 E 9TH ST STE. F
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64683-2763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 660-339-7888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2007007093
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------