Provider Demographics
NPI:1851369656
Name:VIEL, JASON RANDALL (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:RANDALL
Last Name:VIEL
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9667
Mailing Address - Country:US
Mailing Address - Phone:563-370-3379
Mailing Address - Fax:
Practice Address - Street 1:3385 DEXTER CT
Practice Address - Street 2:SUITE 203
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3494
Practice Address - Country:US
Practice Address - Phone:563-332-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0007112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer