Provider Demographics
NPI:1194710020
Name:JUST, JASON R
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:JUST
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 1:742 LEWISVILLE RD
Mailing Address - Street 2:PO BOX 644
Mailing Address - City:WOODSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43793-9061
Mailing Address - Country:US
Mailing Address - Phone:740-742-2100
Mailing Address - Fax:740-472-2111
Practice Address - Street 1:742 LEWISVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793-9061
Practice Address - Country:US
Practice Address - Phone:740-472-2100
Practice Address - Fax:740-472-2111
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2442075Medicaid
OH2442075Medicaid