Provider Demographics
NPI:1407915887
Name:ANTOINE, JAMY CHRISTOPHER I (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMY
Middle Name:CHRISTOPHER
Last Name:ANTOINE
Suffix:I
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 1:7945 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4605
Mailing Address - Country:US
Mailing Address - Phone:952-448-9355
Mailing Address - Fax:952-443-1333
Practice Address - Street 1:7945 STONE CREEK DR
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4605
Practice Address - Country:US
Practice Address - Phone:952-448-9355
Practice Address - Fax:952-443-1333
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03590OtherMEDICARE GROUP NUMBER
MNC03590OtherMEDICARE GROUP NUMBER
MNU97309Medicare UPIN