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General NPI Number Information
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NPI Number | 1235341298
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Entity Type | Individual
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Provider Name | JASON J NACKLEY DC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 8838 US HIGHWAY 70 W SUITE 700
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City | CLAYTON
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State | NC
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Zip | 27520-4822
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Country | US
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Telephone | 919-553-5505
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Fax | 919-553-9909
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Provider Business Mailing Address
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Address Line | 8838 US HIGHWAY 70 W SUITE 700
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City | CLAYTON
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State | NC
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Zip | 27520-4822
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Country | US
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Telephone | 919-553-5505
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Fax | 919-553-9909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | PENDING
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License Number State | NY
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