Provider Demographics
NPI:1093029639
Name:VANSKYHOCK, JASON A (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:A
Last Name:VANSKYHOCK
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 1:111 E EDWARD ST
Mailing Address - Street 2:PO BOX 672
Mailing Address - City:MESICK
Mailing Address - State:MI
Mailing Address - Zip Code:49668-9575
Mailing Address - Country:US
Mailing Address - Phone:231-885-3220
Mailing Address - Fax:231-326-2112
Practice Address - Street 1:111 E EDWARD ST
Practice Address - Street 2:
Practice Address - City:MESICK
Practice Address - State:MI
Practice Address - Zip Code:49668-9575
Practice Address - Country:US
Practice Address - Phone:231-885-3220
Practice Address - Fax:231-326-2112
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor