Provider Demographics
NPI:1154389286
Name:HAUSE, JASON FRANKLIN (DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:FRANKLIN
Last Name:HAUSE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-5400
Mailing Address - Fax:717-741-3598
Practice Address - Street 1:228 SAINT CHARLES WAY STE 300
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4661
Practice Address - Country:US
Practice Address - Phone:717-812-5400
Practice Address - Fax:717-741-3598
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD112121900Medicaid
PA1022820270002Medicaid
PA6863585OtherCAREFIRST
PA1154389286OtherAETNA
PA50085190OtherCBC
PA1402397OtherHIGHMARK
PA50085190OtherCBC
PA150580FLTMedicare PIN