Provider Demographics
NPI:1447518352
Name:STEJSKAL, JASON LEE
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:LEE
Last Name:STEJSKAL
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 1:1340 280TH AVE
Mailing Address - Street 2:B
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-9753
Mailing Address - Country:US
Mailing Address - Phone:785-639-1667
Mailing Address - Fax:
Practice Address - Street 1:1340 280TH AVE
Practice Address - Street 2:B
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-9753
Practice Address - Country:US
Practice Address - Phone:785-639-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services