Individual
DR. JASON BLACKKETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10 STRATFIELD LN, BELLA VISTA, AR 72714-5743
(479) 876-2042
Mailing address
10 STRATFIELD LN, BELLA VISTA, AR 72714-5743
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15700
AR
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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