Provider Demographics
NPI:1871949578
Name:LAIR, JAIME (ATC)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:LAIR
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 1:1726 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4340
Mailing Address - Country:US
Mailing Address - Phone:712-363-1676
Mailing Address - Fax:
Practice Address - Street 1:20 W 6TH ST STE 1
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-3901
Practice Address - Country:US
Practice Address - Phone:712-580-2022
Practice Address - Fax:712-580-2024
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0009612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer