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Individual
JASON S LITTLEDIKE
Active
Individual
JASON S LITTLEDIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
48738752401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48738752400001
BCBS PROVIDER ID#
UT
01
—
48738752402001
WRHN PROVIDER ID
TX
01
—
64-00582
UNITED HEALTHCARE ID#
—
01
—
64411
PEHP PROVIDER ID
UT
05
—
D3911/870578539003
—
UT
01
—
QM0000076331
ALTIUS PROVIDER ID
UT
Enumeration date
07/29/2005
Last updated
04/18/2008
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