Provider Demographics
NPI:1578317590
Name:SHANAHAN, JAMIELEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIELEE
Middle Name:
Last Name:SHANAHAN
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 1:25 MESSENGER ST STE 7
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-5012
Mailing Address - Country:US
Mailing Address - Phone:774-307-0074
Mailing Address - Fax:
Practice Address - Street 1:25 MESSENGER ST STE 7
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-5012
Practice Address - Country:US
Practice Address - Phone:774-307-0074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACHI3312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor