Provider Demographics
NPI:1669844387
Name:TROMBLEY, JASON (AP, LMT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:TROMBLEY
Suffix:
Gender:M
Credentials:AP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 FAIRMONT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-2249
Mailing Address - Country:US
Mailing Address - Phone:304-282-5553
Mailing Address - Fax:
Practice Address - Street 1:990 FAIRMONT RD
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-2249
Practice Address - Country:US
Practice Address - Phone:304-282-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist