Doctor Name: | DR. RICKY DEWAYNE JENNINGS |
NPI Number: | 1225162258 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | 8360 |
Business Practice Address: | 3401 W Airport Fwy Suite 101 Irving, TX - 750625924 |
Business Phone Number: | 2143340125 |
Business Fax Number: | |
Mailing Address: | 2510 Glen Ct, IRVING |
State: | TX |
Postal Code: | 750626637 |
Phone Number: | 9722581983 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 05/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 8360 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |