Provider Demographics
NPI:1396952404
Name:BRAME, JASON W (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:W
Last Name:BRAME
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2725 JAMES SANDERS BLVD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:PODUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8401
Mailing Address - Country:US
Mailing Address - Phone:270-554-5114
Mailing Address - Fax:270-554-5021
Practice Address - Street 1:2725 JAMES SANDERS BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:PODUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8401
Practice Address - Country:US
Practice Address - Phone:270-554-5114
Practice Address - Fax:270-554-5021
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3259111N00000X
KY5154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
00436003Medicare PIN