Provider Demographics
NPI:1912786617
Name:JASON E DAVIS, DC, PLLC
Entity type:Organization
Organization Name:JASON E DAVIS, DC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-348-9546
Mailing Address - Street 1:9623 BAILEY RD STE 205
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9448
Mailing Address - Country:US
Mailing Address - Phone:704-237-4540
Mailing Address - Fax:
Practice Address - Street 1:9623 BAILEY RD STE 205
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-9448
Practice Address - Country:US
Practice Address - Phone:704-237-4540
Practice Address - Fax:704-709-8386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty