Provider Demographics
NPI:1679955652
Name:BEHR, JAMIE
Entity type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:
Last Name:BEHR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-1179
Mailing Address - Country:US
Mailing Address - Phone:928-502-6400
Mailing Address - Fax:928-502-6749
Practice Address - Street 1:7150 E 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-1179
Practice Address - Country:US
Practice Address - Phone:928-502-6400
Practice Address - Fax:928-502-6749
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer