Provider Demographics
NPI:1831721075
Name:KINLEN, JAMIE MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:KINLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 COLLEGE HILLS BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-8425
Mailing Address - Country:US
Mailing Address - Phone:325-949-1518
Mailing Address - Fax:325-223-9290
Practice Address - Street 1:2412 COLLEGE HILLS BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-8425
Practice Address - Country:US
Practice Address - Phone:325-949-1518
Practice Address - Fax:325-223-9290
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor