Individual
JASON BASIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2342 OAK TRACE ST, AUSTINTOWN, OH 44515-4921
(330) 402-0406
Mailing address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-7540
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
019434
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/06/2017
Last updated
11/18/2020
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