Provider Demographics
NPI:1598899726
Name:PATERNOSTER, JAMIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:PATERNOSTER
Suffix:
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 1:20742 HALL RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1537
Mailing Address - Country:US
Mailing Address - Phone:586-468-4461
Mailing Address - Fax:586-468-3636
Practice Address - Street 1:20742 HALL RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-1537
Practice Address - Country:US
Practice Address - Phone:586-468-4461
Practice Address - Fax:586-468-3636
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor