Provider Demographics
NPI:1063517837
Name:STEINHOUSER, JASON BRYAN (DC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:BRYAN
Last Name:STEINHOUSER
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 1:124 MAINE ST STE 215
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2078
Mailing Address - Country:US
Mailing Address - Phone:207-729-4645
Mailing Address - Fax:207-721-1189
Practice Address - Street 1:124 MAINE ST STE 215
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2078
Practice Address - Country:US
Practice Address - Phone:207-729-4645
Practice Address - Fax:207-721-1189
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2016-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1356111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME008401Medicare PIN