Provider Demographics
NPI:1952471534
Name:JUELIS, AMY NYREN (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:NYREN
Last Name:JUELIS
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 1:210 WORCESTER ST
Mailing Address - Street 2:STE 1L
Mailing Address - City:NORTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01536-1289
Mailing Address - Country:US
Mailing Address - Phone:508-839-4835
Mailing Address - Fax:
Practice Address - Street 1:210 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:NORTH GRAFTON
Practice Address - State:MA
Practice Address - Zip Code:01536-1289
Practice Address - Country:US
Practice Address - Phone:508-839-4835
Practice Address - Fax:508-839-4837
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJUY45494Medicare ID - Type Unspecified