Provider Demographics
NPI:1992001143
Name:SWINTON, JASON THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:THOMAS
Last Name:SWINTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JASON
Other - Middle Name:THOMAS
Other - Last Name:SWINTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2000 WINTON ROAD S
Mailing Address - Street 2:BLDG 3, STE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-440-4901
Mailing Address - Fax:585-448-0054
Practice Address - Street 1:2000 WINTON ROAD S
Practice Address - Street 2:BLDG 3, STE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-440-4901
Practice Address - Fax:585-448-0054
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012143-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ40077329Medicare PIN