Provider Demographics
NPI:1578021390
Name:HAMRICK, JASON (DC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HAMRICK
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 1:3054 E REED RD
Mailing Address - Street 2:
Mailing Address - City:MAZON
Mailing Address - State:IL
Mailing Address - Zip Code:60444-6219
Mailing Address - Country:US
Mailing Address - Phone:515-480-5084
Mailing Address - Fax:
Practice Address - Street 1:3054 E REED RD
Practice Address - Street 2:
Practice Address - City:MAZON
Practice Address - State:IL
Practice Address - Zip Code:60444-6219
Practice Address - Country:US
Practice Address - Phone:515-480-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor