Provider Demographics
NPI:1972673283
Name:MINSKY, JASON B (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:B
Last Name:MINSKY
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 1:1309 E SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-4324
Mailing Address - Country:US
Mailing Address - Phone:704-296-9090
Mailing Address - Fax:704-296-9584
Practice Address - Street 1:1309 E SUNSET DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4324
Practice Address - Country:US
Practice Address - Phone:704-296-9090
Practice Address - Fax:704-296-9584
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC3836A595Medicare PIN