Provider Demographics
NPI:1609021443
Name:GRAF, JASON ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ALLEN
Last Name:GRAF
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 1:265 RACINE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8745
Mailing Address - Country:US
Mailing Address - Phone:910-798-5560
Mailing Address - Fax:910-798-5561
Practice Address - Street 1:265 RACINE DR STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8745
Practice Address - Country:US
Practice Address - Phone:910-798-5560
Practice Address - Fax:910-798-5561
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor