Provider Demographics
NPI:1467649145
Name:ADDISON, JASON FLOYD (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:FLOYD
Last Name:ADDISON
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 1:3375 CHASTAIN GARDENS DR NW STE 160
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3700
Mailing Address - Country:US
Mailing Address - Phone:678-809-5773
Mailing Address - Fax:678-723-6951
Practice Address - Street 1:3375 CHASTAIN GARDENS DR NW STE 160
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3700
Practice Address - Country:US
Practice Address - Phone:678-809-5773
Practice Address - Fax:678-723-6951
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor