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DR. JASON BLACKKETTER D.C.

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1063744365

Individual Registrant:
DR. JASON  BLACKKETTER D.C.
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: --

Contact information for business:
10 STRATFIELD LN  BELLA VISTA, AR 72714-5743 US
Tel: --  Fax: --

Registration Information:
NPI: 1063744365
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
AR15700

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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