Provider Demographics
NPI:1346424553
Name:FREY, JASON AARON (RD)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:AARON
Last Name:FREY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 STATE ROAD 229 SOUTH
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006
Mailing Address - Country:US
Mailing Address - Phone:812-209-9656
Mailing Address - Fax:
Practice Address - Street 1:141 BATESVILLE SHOPPING VILLAGE
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006
Practice Address - Country:US
Practice Address - Phone:812-932-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered