Basic Information
Provider Information
NPI: 1205007960
EntityType: 2
ReplacementNPI:  
OrganizationName: DR RICK J JAMINET, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 4127
Address2:  
City: ROANOKE
State: VA
PostalCode: 240150127
CountryCode: US
TelephoneNumber: 5409819394
FaxNumber: 5403447154
Practice Location
Address1: 20607 TIMBERLAKE RD
Address2: SUITE A
City: LYNCHBURG
State: VA
PostalCode: 245027206
CountryCode: US
TelephoneNumber: 4342399077
FaxNumber: 4342394346
Other Information
ProviderEnumerationDate: 03/20/2008
LastUpdateDate: 09/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JAMINET
AuthorizedOfficialFirstName: RICK
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4342399077
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DC
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X0104000743VAY193400000X SINGLE SPECIALTY GROUPChiropractic ProvidersChiropractor 

No ID Information.


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