Doctor Name: | DR. JASON R COBURN |
NPI Number: | 1073765954 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 70 011737 |
Business Practice Address: | 87 West Main St. Dryden, NY - 13053 |
Business Phone Number: | 6072831280 |
Business Fax Number: | |
Mailing Address: | Po Box 113, FREEVILLE |
State: | NY |
Postal Code: | 130680113 |
Phone Number: | 6072831280 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2008 |
NPI Last Update Date: | 05/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 70 011737 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |