Doctor Name: | MR. JASON PERINGER |
NPI Number: | 1720277809 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC, CSCS, LMT |
License Number: | MA28173 |
Business Practice Address: | 76 Main St # 334 Vineyard Haven, MA - 025680334 |
Business Phone Number: | 5086938020 |
Business Fax Number: | |
Mailing Address: | 76 Main St, # 334 VINEYARD HAVEN |
State: | MA |
Postal Code: | 025680334 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/15/2007 |
NPI Last Update Date: | 10/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA28173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |