Provider Demographics
NPI:1104877349
Name:SAULTER, JAMIE TODD (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:TODD
Last Name:SAULTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7338
Mailing Address - Country:US
Mailing Address - Phone:207-861-8221
Mailing Address - Fax:207-861-7900
Practice Address - Street 1:81 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-7338
Practice Address - Country:US
Practice Address - Phone:207-861-8221
Practice Address - Fax:207-861-7900
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128570099Medicaid
MEMM2465Medicare PIN
ME128570099Medicaid