Provider Demographics
NPI:1174614598
Name:TINOOSH, JENNIFER JINUS (DC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JINUS
Last Name:TINOOSH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:JINOOS
Other - Middle Name:JENNY
Other - Last Name:TINOOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18853 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4485
Mailing Address - Country:US
Mailing Address - Phone:434-316-0100
Mailing Address - Fax:434-316-0103
Practice Address - Street 1:18853 FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4485
Practice Address - Country:US
Practice Address - Phone:434-316-0100
Practice Address - Fax:434-316-0103
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA257720OtherANTHEM
VA7212157002OtherCIGNA
VA257720OtherANTHEM
U78557Medicare UPIN