Provider Demographics
NPI:1588950802
Name:APPLINGLMT, JASON DEWAYNE (LMT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:DEWAYNE
Last Name:APPLINGLMT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1109 LOVERS LN
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-6114
Mailing Address - Country:US
Mailing Address - Phone:270-904-4111
Mailing Address - Fax:270-904-4333
Practice Address - Street 1:1109 LOVERS LN
Practice Address - Street 2:SUITE 3
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-6114
Practice Address - Country:US
Practice Address - Phone:270-904-4111
Practice Address - Fax:270-904-4333
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0761225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist