Individual
JENNIFER RENEE MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1826 N GRAND AVE, CONNERSVILLE, IN 47331-2859
(765) 825-9343
Mailing address
1826 N GRAND AVE, CONNERSVILLE, IN 47331-2859
(765) 825-9343
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002523A
IN
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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