Basic Information
| Provider Information | |||||||||
| NPI: | 1396952404 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRAME | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2725 JAMES SANDERS BLVD. | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PODUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420018401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705545114 | ||||||||
| FaxNumber: | 2705545021 | ||||||||
| Practice Location | |||||||||
| Address1: | 2725 JAMES SANDERS BLVD. | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PODUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420018401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2705545114 | ||||||||
| FaxNumber: | 2705545021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 02/16/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 3259 | SC | N | Chiropractic Providers | Chiropractor | 111N00000X | 5154 | KY | Y | Chiropractic Providers | Chiropractor |
No ID Information.