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NPI Code Detail

MEDICARE: JENNIFER WINELAND OMT

MEDICARE: JENNIFER WINELAND OMT
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
1124Q00000XDental Hygienist2902015642MI

General Provider Information

NPI Number : 1518795632
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WINELAND OMT
Provider Business Mailing Address
First Line : 2555 SPRING ARBOR RD
Second Line :
City : JACKSON
State : MI
Zip : 49203-3601
Country : US
Telephone Number : 517-787-5210
Fax Number :
Provider Business Practice Location Address
First Line : 2555 SPRING ARBOR RD
Second Line :
City : JACKSON
State : MI
Zip : 49203-3601
Country : US
Telephone Number : 517-787-5210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 07/22/2024

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Directions to “ JENNIFER WINELAND OMT” Practice Location

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