Provider Demographics
NPI:1164419669
Name:JAROLIMEK, JOEL VICTOR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:VICTOR
Last Name:JAROLIMEK
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:PO BOX 10044
Mailing Address - Street 2:660 2ND AVE N
Mailing Address - City:KETCHUM
Mailing Address - State:ID
Mailing Address - Zip Code:83340-8044
Mailing Address - Country:US
Mailing Address - Phone:208-725-0000
Mailing Address - Fax:208-725-0066
Practice Address - Street 1:660 2ND AVE N
Practice Address - Street 2:
Practice Address - City:KETCHUM
Practice Address - State:ID
Practice Address - Zip Code:83340
Practice Address - Country:US
Practice Address - Phone:208-725-0000
Practice Address - Fax:208-725-0066
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134873Medicare ID - Type Unspecified
T41169Medicare UPIN