Provider Demographics
NPI:1386901718
Name:ADAMS, JAMIE BETH (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:BETH
Last Name:ADAMS
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 1:2125 PACE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-6659
Mailing Address - Country:US
Mailing Address - Phone:770-689-6987
Mailing Address - Fax:
Practice Address - Street 1:2125 PACE ST
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-6659
Practice Address - Country:US
Practice Address - Phone:770-689-6987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO08921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I355672OtherMEDICARE PTAN