Healthcare Provider Details

I. General information

NPI: 1568375368
Provider Name (Legal Business Name): JASON WEBER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7124 COMMONS DR UNIT D
CHEYENNE WY
82009-2620
US

IV. Provider business mailing address

7124 COMMONS DR UNIT D
CHEYENNE WY
82009-2620
US

V. Phone/Fax

Practice location:
  • Phone: 307-634-4242
  • Fax:
Mailing address:
  • Phone: 307-634-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number00888
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: