Provider Demographics
NPI:1578835708
Name:JASON T. COE D.C. LLC
Entity Type:Organization
Organization Name:JASON T. COE D.C. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACITC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:T
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-469-4411
Mailing Address - Street 1:22 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4564
Mailing Address - Country:US
Mailing Address - Phone:330-544-2225
Mailing Address - Fax:
Practice Address - Street 1:22 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4564
Practice Address - Country:US
Practice Address - Phone:330-544-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty