MEDICARE: DR. JAMIE LYNN FLEAGANE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH0006907	FL

General Provider Information

NPI Number	:	1922130061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE LYNN FLEAGANE D.C.

Provider Business Mailing Address
First Line	:	8136 BRIDGEWATER CT APT C
Second Line	:
City	:	LAKE CLARKE SHORES
State	:	FL
Zip	:	33406-8479
Country	:	US
Telephone Number	:	561-968-0690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 FOREST HILL BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	561-433-9999
Fax Number	:	561-433-9917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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