Provider Demographics
NPI:1275667297
Name:HAMMERSLAND, JAMIE LEE (DC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:HAMMERSLAND
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 697
Mailing Address - Street 2:
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-0697
Mailing Address - Country:US
Mailing Address - Phone:563-245-1151
Mailing Address - Fax:563-245-1186
Practice Address - Street 1:690 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9041
Practice Address - Country:US
Practice Address - Phone:563-245-1151
Practice Address - Fax:563-245-1186
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1447558648OtherBCBS
IA1447558648Medicaid
IA1447558648OtherBCBS