Provider Demographics
NPI:1154355238
Name:ENOS, JAMIE M (DC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:ENOS
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 1:12 CALEF ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4345
Mailing Address - Country:US
Mailing Address - Phone:401-921-6550
Mailing Address - Fax:401-921-6552
Practice Address - Street 1:12 CALEF ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4345
Practice Address - Country:US
Practice Address - Phone:401-921-6550
Practice Address - Fax:401-921-6552
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP 00459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI323446OtherBLUE CROSS
RI409286OtherBLUE CHIP OF RI
RI44 01191OtherUNITED HEALTH CARE
RI44 01191OtherUNITED HEALTH CARE
RI323446OtherBLUE CROSS