Healthcare Provider Details

I. General information

NPI: 1891757696
Provider Name (Legal Business Name): JASON ALBERT MARKIJOHN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S. COLORADO BLVD. SUITE 300
GLENDALE CO
80246-3445
US

IV. Provider business mailing address

400 S. COLORADO BLVD. SUITE 300
GLENDALE CO
80246-3445
US

V. Phone/Fax

Practice location:
  • Phone: 303-759-5575
  • Fax: 303-759-5589
Mailing address:
  • Phone: 303-759-5575
  • Fax: 303-759-5589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8544
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: