Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CO5441 | CO |
NPI | 1427124395 |
---|---|
Provider Name | Dr. Jason Wade Haas |
First Address | Windsor, CO 80550-4709 |
Second Address | Windsor, CO 80550-4709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 06/06/2008 |