Healthcare Provider Details

I. General information

NPI: 1730104845
Provider Name (Legal Business Name): JASON A. HUTCHISON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 NE 96TH ST SUITE B
LIBERTY MO
64068-1348
US

IV. Provider business mailing address

1508 NE 96TH ST SUITE B
LIBERTY MO
64068-1348
US

V. Phone/Fax

Practice location:
  • Phone: 816-407-7200
  • Fax: 816-407-7222
Mailing address:
  • Phone: 816-407-7200
  • Fax: 816-407-7222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDRC2006008609
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: