Provider Demographics
NPI:1831237353
Name:NOETH, JAMIE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:MARIE
Last Name:NOETH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:178 PLANK ROAD
Mailing Address - City:MONGAUP VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12762-0415
Mailing Address - Country:US
Mailing Address - Phone:845-583-6151
Mailing Address - Fax:845-583-6299
Practice Address - Street 1:12 PLANK ROAD
Practice Address - Street 2:
Practice Address - City:MONGAUP VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12762-0415
Practice Address - Country:US
Practice Address - Phone:845-583-6151
Practice Address - Fax:845-583-6299
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor