Individual
DR. JASON BOLLENBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2191 HILLSBORO RD, SUITE A, FRANKLIN, TN 37069-6223
(618) 420-0409
(615) 465-6682
Mailing address
2191 HILLSBORO RD, SUITE A, FRANKLIN, TN 37069-6223
(618) 420-0409
(615) 465-6682
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-009505
IL
111N00000X
Chiropractor
Primary
2614
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210868
MEDICARE GROUP - MCC
IL
01
—
210868001
MEDICARE PTAN - INDIVIDUAL
IL
01
—
37-1361254
TAX ID - MCC
IL
01
—
601151600
US DEPT OF LABOR
IL
01
—
620543
HEALTHLINK
IL
01
—
681087
UHC#
IL
01
—
7521142
BC/BS GROUP MCC
IL
Enumeration date
07/07/2005
Last updated
06/12/2014
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