Provider Demographics
NPI:1558500132
Name:CHERRY, JOHN JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JASON
Last Name:CHERRY
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 1:605 E ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5502
Mailing Address - Country:US
Mailing Address - Phone:530-743-2093
Mailing Address - Fax:530-743-3301
Practice Address - Street 1:605 E ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5502
Practice Address - Country:US
Practice Address - Phone:530-743-2093
Practice Address - Fax:530-743-3301
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor