Provider Demographics
NPI:1316086119
Name:POSTLETHWAIT, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:POSTLETHWAIT
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 1:160 BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-2917
Mailing Address - Country:US
Mailing Address - Phone:731-986-4411
Mailing Address - Fax:
Practice Address - Street 1:160 BROWNING AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-2917
Practice Address - Country:US
Practice Address - Phone:731-986-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator