Provider Demographics
NPI:1275896524
Name:WHEELER, JASON BRUCE (DPT)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRUCE
Last Name:WHEELER
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 1:8687 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9504
Mailing Address - Country:US
Mailing Address - Phone:812-361-2194
Mailing Address - Fax:
Practice Address - Street 1:8687 CREEKWOOD DR
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9504
Practice Address - Country:US
Practice Address - Phone:812-361-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013728225100000X
OHPT013728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist