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DR. JASON BLACKKETTER D.C.
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1063744365
Individual Registrant:DR. JASON BLACKKETTER D.C.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
10 STRATFIELD LN BELLA VISTA, AR 72714-5743 US
Tel: 479-876-2042 Fax: --
Tel: 479-876-2042 Fax: --
Contact information for business:
10 STRATFIELD LN BELLA VISTA, AR 72714-5743 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1063744365
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | AR | 15700 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
