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General NPI Number Information
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NPI Number | 1245770767
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Entity Type | Individual
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Provider Name | JASON RYAN NAQUIN D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 4740 FLINTRIDGE DR STE 130
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918
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Country | US
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Telephone | 719-917-1000
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Fax | 719-667-1971
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Provider Business Mailing Address
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Address Line | 4740 FLINTRIDGE DR STE 130
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-4273
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Country | US
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Telephone | 719-917-1000
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Fax | 719-667-1971
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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 | CHR.0007578
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11892
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License Number State | FL
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