Provider Demographics
NPI:1801953898
Name:SPICKELMIER, JAMIE (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:SPICKELMIER
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 1:5642 S EASTERN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-2310
Mailing Address - Country:US
Mailing Address - Phone:702-736-8535
Mailing Address - Fax:702-736-8520
Practice Address - Street 1:5642 S EASTERN AVE STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-2310
Practice Address - Country:US
Practice Address - Phone:702-736-8535
Practice Address - Fax:702-736-8520
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor