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JASON ALLEN SOUSA DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1558439398

Individual Registrant:
 JASON ALLEN SOUSA DC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1127 TOLLAND TURNPIKE SUITE 102 MANCHESTER, CO 06042 US
Tel: 860-432-7432  Fax: 860-432-9049

Contact information for business:
1127 TOLLAND TURNPIKE SUITE 102 MANCHESTER, CO 06042 US
Tel: 860-432-7432  Fax: 860-432-9049

Registration Information:
NPI: 1558439398
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
MECR1692
N111N00000XChiropractic Providers
Chiropractor
CT001722

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
GROUP MEDICAREC0389801
LICENSECR1692ME01




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