| Doctor Name: | JENNIFER GOMBERG VOTTA |
| NPI Number: | 1134485683 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 5101022402 |
| Business Practice Address: | 965 Fee Rd East Fee Hall Room A233 East Lansing, MI - 488246410 |
| Business Phone Number: | 5173534362 |
| Business Fax Number: | 5174320927 |
| Mailing Address: | 965 Fee Rd, East Fee Hall Room A233 EAST LANSING |
| State: | MI |
| Postal Code: | 488246410 |
| Phone Number: | 5173534362 |
| Fax Number: | 5174320927 |
| NPI Enumeration Date: | 04/10/2012 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101022402 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |