Provider Demographics
NPI:1053171173
Name:JENNINGS, SKYLER (DC)
Entity type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CEDAR PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2783
Mailing Address - Country:US
Mailing Address - Phone:512-222-4222
Mailing Address - Fax:512-857-5159
Practice Address - Street 1:205 CEDAR PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2783
Practice Address - Country:US
Practice Address - Phone:512-222-4222
Practice Address - Fax:512-857-5159
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor