Provider Demographics
NPI:1750562443
Name:CAHILL, JASON WAYNE (DC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:WAYNE
Last Name:CAHILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 LEHMAN DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-533-0303
Mailing Address - Fax:719-533-0304
Practice Address - Street 1:6210 LEHMAN DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-533-0303
Practice Address - Fax:719-533-0304
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6156111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1891822193OtherGROUP NPI
CO47833OtherGROUP PTAN
CO47833OtherGROUP PTAN
811555Medicare PIN