Provider Demographics
NPI:1841517448
Name:JASON HAMM DCPC
Entity type:Organization
Organization Name:JASON HAMM DCPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-336-5022
Mailing Address - Street 1:1330 LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360
Mailing Address - Country:US
Mailing Address - Phone:712-336-5022
Mailing Address - Fax:712-336-5044
Practice Address - Street 1:1330 LAKE ST.
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360
Practice Address - Country:US
Practice Address - Phone:712-336-5022
Practice Address - Fax:712-336-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty