Provider Demographics
NPI:1427285782
Name:STUGART, JASON (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:STUGART
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 1:44115 WOODRIDGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6824
Mailing Address - Country:US
Mailing Address - Phone:571-291-9359
Mailing Address - Fax:
Practice Address - Street 1:44115 WOODRIDGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6824
Practice Address - Country:US
Practice Address - Phone:571-291-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-14
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor