Provider Demographics
NPI:1992025159
Name:ALLEN, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PRINCE DR
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-5709
Mailing Address - Country:US
Mailing Address - Phone:610-551-7272
Mailing Address - Fax:
Practice Address - Street 1:1340 SWEDESFORD RD
Practice Address - Street 2:INSIDE DEVON FITNESS CLUB
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1087
Practice Address - Country:US
Practice Address - Phone:610-551-7272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No172M00000XOther Service ProvidersMechanotherapist