Provider Demographics
NPI:1215199211
Name:REGIS, JASON ALON (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALON
Last Name:REGIS
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 1:4343 SHALLOWFORD RD STE 760
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5084
Mailing Address - Country:US
Mailing Address - Phone:678-352-1948
Mailing Address - Fax:678-352-9267
Practice Address - Street 1:4343 SHALLOWFORD RD STE 760
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5084
Practice Address - Country:US
Practice Address - Phone:678-352-1948
Practice Address - Fax:678-352-9267
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor