Provider Demographics
NPI:1275764268
Name:WIEGEL, JAMIE LEANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LEANNE
Last Name:WIEGEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LEANNE
Other - Last Name:MESSENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 401707
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1707
Mailing Address - Country:US
Mailing Address - Phone:760-244-0035
Mailing Address - Fax:760-244-8589
Practice Address - Street 1:9179 G AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6121
Practice Address - Country:US
Practice Address - Phone:760-244-0035
Practice Address - Fax:760-244-8589
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor