Provider Demographics
NPI:1184862633
Name:JASON J TIEL DC PLLC
Entity type:Organization
Organization Name:JASON J TIEL DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-322-4945
Mailing Address - Street 1:2801 KALISTE SALOOM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7181
Mailing Address - Country:US
Mailing Address - Phone:337-984-8605
Mailing Address - Fax:337-989-7036
Practice Address - Street 1:2801 KALISTE SALOOM RD STE 200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7181
Practice Address - Country:US
Practice Address - Phone:337-984-8605
Practice Address - Fax:337-989-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty