Provider Demographics
NPI:1952428013
Name:EDSALL, JASON RONALD (PHD, LAT, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:RONALD
Last Name:EDSALL
Suffix:
Gender:M
Credentials:PHD, LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHATHAM UNIVERSITY
Mailing Address - Street 2:1 WOODLAND RD
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2927
Mailing Address - Country:US
Mailing Address - Phone:724-309-6687
Mailing Address - Fax:
Practice Address - Street 1:CHATHAM UNIVERSITY
Practice Address - Street 2:1 WOODLAND RD
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-2927
Practice Address - Country:US
Practice Address - Phone:724-309-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0044142255A2300X
PA11020200082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer