Provider Demographics
NPI:1346358066
Name:JOKERST, AIMEE R (DC)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:R
Last Name:JOKERST
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 1:751 W STADIUM BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-4776
Mailing Address - Country:US
Mailing Address - Phone:573-635-2225
Mailing Address - Fax:573-634-5155
Practice Address - Street 1:751 W STADIUM BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-4776
Practice Address - Country:US
Practice Address - Phone:573-635-2225
Practice Address - Fax:573-634-5155
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor