Provider Demographics
NPI:1003125964
Name:NORTH, JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:NORTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 NORTH MAIN STREET
Mailing Address - Street 2:#2
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663
Mailing Address - Country:US
Mailing Address - Phone:801-491-4195
Mailing Address - Fax:801-491-7033
Practice Address - Street 1:1220 N MAIN ST
Practice Address - Street 2:#2
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-4013
Practice Address - Country:US
Practice Address - Phone:801-491-4195
Practice Address - Fax:801-491-7033
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7759187-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor