Provider Demographics
NPI:1194280750
Name:LANNING, JASON L
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:LANNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BIRCH ALY STE 240
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-1477
Mailing Address - Country:US
Mailing Address - Phone:937-949-8044
Mailing Address - Fax:
Practice Address - Street 1:5334 HONEYLEAF WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-4732
Practice Address - Country:US
Practice Address - Phone:937-949-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other