Provider Demographics
NPI:1952530198
Name:REESE, JASON DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DAVID
Last Name:REESE
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 1:1160 S STATE ST
Mailing Address - Street 2:SUITE 180A
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-7160
Mailing Address - Country:US
Mailing Address - Phone:801-226-0932
Mailing Address - Fax:801-226-0933
Practice Address - Street 1:1160 S STATE ST
Practice Address - Street 2:SUITE 180A
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-7160
Practice Address - Country:US
Practice Address - Phone:801-226-0932
Practice Address - Fax:801-226-0933
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT202301-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor