Provider Demographics
NPI:1912325606
Name:MAAS, JAMIE ANGELINE (ATC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANGELINE
Last Name:MAAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 6TH AVE NE
Mailing Address - Street 2:APT 3
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2022
Mailing Address - Country:US
Mailing Address - Phone:763-218-8315
Mailing Address - Fax:
Practice Address - Street 1:301 6TH AVE NE
Practice Address - Street 2:APT 3
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2022
Practice Address - Country:US
Practice Address - Phone:763-218-8315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer