Provider Demographics
NPI:1871676577
Name:MEINSEN, JAMES GREGG (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GREGG
Last Name:MEINSEN
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 1:12 COMMUNITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:NY
Mailing Address - Zip Code:14801
Mailing Address - Country:US
Mailing Address - Phone:607-359-2225
Mailing Address - Fax:607-359-2225
Practice Address - Street 1:12 COMMUNITY DRIVE
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:NY
Practice Address - Zip Code:14801
Practice Address - Country:US
Practice Address - Phone:607-359-2225
Practice Address - Fax:607-359-2225
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0071461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
54676BMedicare ID - Type Unspecified
C071466Medicare UPIN