Provider Demographics
NPI:1780387639
Name:REEDER, JASON (LMT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:REEDER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 READING RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1342
Mailing Address - Country:US
Mailing Address - Phone:513-754-0050
Mailing Address - Fax:513-229-3740
Practice Address - Street 1:808 READING RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1342
Practice Address - Country:US
Practice Address - Phone:513-754-0050
Practice Address - Fax:513-229-3740
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022611225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist