Provider Demographics
NPI:1427167568
Name:WINSECK, JASON WALTER (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:WALTER
Last Name:WINSECK
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 1:45591 DULLES EASTERN PLZ
Mailing Address - Street 2:STE 132
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-8925
Mailing Address - Country:US
Mailing Address - Phone:703-404-0350
Mailing Address - Fax:703-404-0352
Practice Address - Street 1:45591 DULLES EASTERN PLZ
Practice Address - Street 2:STE 132
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-8925
Practice Address - Country:US
Practice Address - Phone:703-404-0350
Practice Address - Fax:703-404-0352
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350001259Medicare ID - Type Unspecified