Provider Demographics
NPI:1639117286
Name:AGUAYO, JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:AGUAYO
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 1:2 TREWIN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59063-8015
Mailing Address - Country:US
Mailing Address - Phone:140-663-3279
Mailing Address - Fax:
Practice Address - Street 1:2212 BROADWATER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4779
Practice Address - Country:US
Practice Address - Phone:140-665-2355
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor