Provider Demographics
NPI:1235341298
Name:NACKLEY, JASON J (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:NACKLEY
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 1:8838 US HIGHWAY 70 W
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4822
Mailing Address - Country:US
Mailing Address - Phone:919-553-5505
Mailing Address - Fax:919-553-9909
Practice Address - Street 1:8838 US HIGHWAY 70 W
Practice Address - Street 2:SUITE 700
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4822
Practice Address - Country:US
Practice Address - Phone:919-553-5505
Practice Address - Fax:919-553-9909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor