Individual
JASON SCOTT OZBOURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 SHERIDAN DR, BENTON, IL 62812-1047
(618) 927-2822
Mailing address
101 TRANSCRAFT DR, ANNA, IL 62906-2114
(618) 833-2179
(618) 833-4596
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011964
IL
261Q00000X
Clinic/Center
038011964
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2011
Last updated
11/30/2017
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