MEDICARE: DR. JENNIFER RENEE WINTON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7750	AZ

General Provider Information

NPI Number	:	1255444055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER RENEE WINTON DC

Provider Business Mailing Address
First Line	:	16515 S 40TH ST STE 131
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0560
Country	:	US
Telephone Number	:	480-704-1050
Fax Number	:	480-704-0109

Provider Business Practice Location Address
First Line	:	16515 S 40TH ST STE 131
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0560
Country	:	US
Telephone Number	:	480-704-1050
Fax Number	:	480-704-0109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	01/06/2019

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