Provider Demographics
NPI:1699978080
Name:JAMISON FAMILY CHIROPRACTIC CENTER, P. C.
Entity type:Organization
Organization Name:JAMISON FAMILY CHIROPRACTIC CENTER, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:862-210-8994
Mailing Address - Street 1:14 FOREST AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5208
Mailing Address - Country:US
Mailing Address - Phone:862-210-8994
Mailing Address - Fax:862-210-8994
Practice Address - Street 1:14 FOREST AVE STE 11
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5208
Practice Address - Country:US
Practice Address - Phone:862-210-8994
Practice Address - Fax:862-210-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC003978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
590756WPPMedicare PIN