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General NPI Number Information
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NPI Number | 1669721692
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Entity Type | Individual
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Provider Name | JASON A HOLLABAUGH D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 7098 LOCKWOOD BLVD STE 7106
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City | BOARDMAN
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State | OH
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Zip | 44512-4064
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Country | US
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Telephone | 330-953-1858
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Fax | 330-954-0789
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Provider Business Mailing Address
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Address Line | 7098 LOCKWOOD BLVD STE 7106
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4064
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Country | US
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Telephone | 330-507-5533
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Fax |
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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 | AJ010434
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License Number State | PA
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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 | DC010641
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4296
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License Number State | OH
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