Provider Demographics
NPI:1114471364
Name:CHRISTNER, JASON JAMES (ATC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:JAMES
Last Name:CHRISTNER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 OAK TREE DR N
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-4336
Mailing Address - Country:US
Mailing Address - Phone:440-225-5156
Mailing Address - Fax:
Practice Address - Street 1:4700 BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-5542
Practice Address - Country:US
Practice Address - Phone:440-233-6313
Practice Address - Fax:440-233-6311
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0018722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer