Provider Demographics
NPI:1588841852
Name:STE. MARIE, JEREMY (DC, PC)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:STE. MARIE
Suffix:
Gender:M
Credentials:DC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HILL ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05828-9653
Mailing Address - Country:US
Mailing Address - Phone:802-684-9707
Mailing Address - Fax:
Practice Address - Street 1:32 HILL ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VT
Practice Address - Zip Code:05828-9653
Practice Address - Country:US
Practice Address - Phone:802-684-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060001116111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT5705962OtherFIRST HEALTH
VT59219OtherBLUE CROSS/BLUE SHIELD
VT674860OtherCIGNA
VT5705962OtherFIRST HEALTH