Provider Demographics
NPI:1306969209
Name:JAMIESON, THOMAS BROS (LAC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BROS
Last Name:JAMIESON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:57 WIGHT STREET
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915
Mailing Address - Country:US
Mailing Address - Phone:207-338-1796
Mailing Address - Fax:207-338-1796
Practice Address - Street 1:224 STATE ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5434
Practice Address - Country:US
Practice Address - Phone:207-990-0188
Practice Address - Fax:207-338-1796
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC164171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist