Provider Demographics
NPI:1154436301
Name:EAMES, JENNIFER F (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:EAMES
Suffix:
Gender:F
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-0003
Mailing Address - Country:US
Mailing Address - Phone:508-748-6633
Mailing Address - Fax:508-748-6649
Practice Address - Street 1:238 WAREHAM RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1166
Practice Address - Country:US
Practice Address - Phone:508-748-6633
Practice Address - Fax:508-748-6649
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
04C275OtherACN PROVIDER ID
AA8569OtherHPHC PROVIDER ID
Y36999OtherBCBS OF MA PROVIDER ID
1193767OtherAETNA PROVIDER ID
696220OtherUHC PROVIDER ID
494610OtherTUFTS PROVIDER ID
000000025416OtherBMC HEALTHNET PROVIDER ID
000000025416OtherBMC HEALTHNET PROVIDER ID
MAY4559001Medicare PIN