MEDICARE: JENNIFER PRICE D.C.

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	12609	TX

General Provider Information

NPI Number	:	1710388996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER PRICE D.C.

Provider Business Mailing Address
First Line	:	9415 BROADWAY ST STE 121
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-480-7000
Fax Number	:	281-480-7017

Provider Business Practice Location Address
First Line	:	9415 BROADWAY ST STE 121
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8094
Country	:	US
Telephone Number	:	281-480-7000
Fax Number	:	281-480-7017

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

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	09/08/2014

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