Healthcare Provider Details

I. General information

NPI: 1659466340
Provider Name (Legal Business Name): JASON CURTIS NIELSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 W INDIAN SCHOOL RD STE 138
PHOENIX AZ
85037-1904
US

IV. Provider business mailing address

9150 W INDIAN SCHOOL RD STE 138
PHOENIX AZ
85037-1904
US

V. Phone/Fax

Practice location:
  • Phone: 623-772-1444
  • Fax: 623-772-1333
Mailing address:
  • Phone: 623-772-1444
  • Fax: 623-772-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7303
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number7303
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: