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NPI Code Detail

MEDICARE: DR. JENNIFER LYNN POWELL CNIM, DABNM, D.C.

MEDICARE: DR. JENNIFER LYNN POWELL CNIM, DABNM, 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
1111N00000XChiropractor10078TX
2246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1760531024
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER LYNN POWELL CNIM, DABNM, D.C.
Provider Business Mailing Address
First Line : 14983 BOAZ LN
Second Line :
City : LINDALE
State : TX
Zip : 75771-4801
Country : US
Telephone Number : 972-786-6167
Fax Number : 903-882-7748
Provider Business Practice Location Address
First Line : 14983 BOAZ LN
Second Line :
City : LINDALE
State : TX
Zip : 75771-4801
Country : US
Telephone Number : 972-786-6167
Fax Number : 903-882-7748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 01/13/2022

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