Provider Demographics
NPI:1376799189
Name:ENGEL, JAMIE MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:MICHELLE
Last Name:ENGEL
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 1:315 RANTOUL ST
Mailing Address - Street 2:UNITS 317 & 319
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4331
Mailing Address - Country:US
Mailing Address - Phone:818-438-1570
Mailing Address - Fax:
Practice Address - Street 1:315 RANTOUL ST
Practice Address - Street 2:UNITS 317 & 319
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4331
Practice Address - Country:US
Practice Address - Phone:818-438-1570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1222901Medicare PIN