Provider Demographics
NPI:1568217016
Name:UTZ, JASON N (DPT, PT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:N
Last Name:UTZ
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11945 LITHOPOLIS RD NW # 2
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9585
Mailing Address - Country:US
Mailing Address - Phone:740-785-5231
Mailing Address - Fax:740-785-5489
Practice Address - Street 1:1506 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8124
Practice Address - Country:US
Practice Address - Phone:740-785-5231
Practice Address - Fax:740-785-5489
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT021063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist