Vondrak, Jennifer Fanchon
Vondrak, Jennifer Fanchon is an sole proprietor health care provider with primary practice located at 102 Boyer St. Suite B, Wall Lake IA 51466. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Vondrak, Jennifer Fanchon can be contacted via phone (712) 664-2054.Contact Information
Primary practice address
102 Boyer St. Suite B
Wall Lake IA 51466
Phone: (712) 664-2054
Fax: (712) 664-2053
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | AO6224 | Iowa |
Profile Details
| NPI number | 1689643736 |
|---|---|
| LBN Legal business name | Vondrak, Jennifer Fanchon |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Jan 9th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689643736 | NPPES |
| Iowa | MEDICAID | 1198671 |
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