Individual
DR. JENNIFER ELYSE LYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1867 SUMMER ST, STAMFORD, CT 06905-5016
(203) 975-7000
(203) 975-0876
Mailing address
114 WOODSIDE GRN APT 2C, STAMFORD, CT 06905-4913
(203) 355-0689
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001402
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001402CT01
BLUE CROSS ID
CT
Enumeration date
10/03/2006
Last updated
07/08/2007
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