Provider Demographics
NPI:1013976992
Name:AMES, MICHAEL RAYMOND (DC, DACBN, CCN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAYMOND
Last Name:AMES
Suffix:
Gender:M
Credentials:DC, DACBN, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S WEST END BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1424
Mailing Address - Country:US
Mailing Address - Phone:215-536-4610
Mailing Address - Fax:
Practice Address - Street 1:609 S WEST END BLVD STE 1
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1424
Practice Address - Country:US
Practice Address - Phone:215-536-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003913L111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0386044000OtherKEYSTONE/ BC & BS
PA2048415OtherAETNA
PA50004518OtherCAPITAL BLUE CROSS