Provider Demographics
NPI:1558500132
Name:CHERRY, JOHN JASON (DC, MS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JASON
Last Name:CHERRY
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 CHALICE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PLUMAS LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95961-8970
Mailing Address - Country:US
Mailing Address - Phone:530-441-8675
Mailing Address - Fax:
Practice Address - Street 1:123 MARGARET LN
Practice Address - Street 2:SUITEA2
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5268
Practice Address - Country:US
Practice Address - Phone:530-575-9104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor