Provider Demographics
NPI:1801618384
Name:JASON KINDER DC LLC
Entity type:Organization
Organization Name:JASON KINDER DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:KINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-742-1955
Mailing Address - Street 1:4157 S HARVARD AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2606
Mailing Address - Country:US
Mailing Address - Phone:918-742-1955
Mailing Address - Fax:
Practice Address - Street 1:4157 S HARVARD AVE STE 117
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2606
Practice Address - Country:US
Practice Address - Phone:918-742-1955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty