Provider Demographics
NPI:1477076545
Name:FAIPLER, JASON THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:THOMAS
Last Name:FAIPLER
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 1:1602 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-5522
Mailing Address - Country:US
Mailing Address - Phone:850-435-7777
Mailing Address - Fax:850-435-3132
Practice Address - Street 1:1602 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-5522
Practice Address - Country:US
Practice Address - Phone:850-435-7777
Practice Address - Fax:850-435-3132
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12258111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor