Provider Demographics
NPI:1174618201
Name:FEENEY, JENNIFER MELISSA (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MELISSA
Last Name:FEENEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:MELISSA
Other - Last Name:SWIATOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2020 NORWICH NEW LONDON TPKE UNIT 9
Mailing Address - Street 2:
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-1374
Mailing Address - Country:US
Mailing Address - Phone:860-892-8122
Mailing Address - Fax:860-892-8151
Practice Address - Street 1:2020 NORWICH NEW LONDON TPKE UNIT 9
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-1374
Practice Address - Country:US
Practice Address - Phone:203-470-5038
Practice Address - Fax:860-892-8151
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT9845639Medicare PIN