Provider Demographics
NPI:1053585521
Name:HEDDEN, JENNIFER MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:HEDDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:HEDDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:911 GRAHAM RD
Mailing Address - Street 2:SUITE 66
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1169
Mailing Address - Country:US
Mailing Address - Phone:330-945-4700
Mailing Address - Fax:330-945-5876
Practice Address - Street 1:911 GRAHAM RD
Practice Address - Street 2:SUITE 66
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1169
Practice Address - Country:US
Practice Address - Phone:330-945-4700
Practice Address - Fax:330-945-5876
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor