Individual
DR. AMANDA MARIE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
137 N WALNUT ST, SUITE 5, BYRON, IL 61010-1475
(815) 234-2222
Mailing address
PO BOX 969, BYRON, IL 61010-0969
(815) 757-0299
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011712
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400170302
MEDICARE PTAN
IL
Enumeration date
06/11/2010
Last updated
03/27/2023
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