Individual
DR. JASON ROBERT GOLEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4234 E WESTERN DR, COTTONWOOD, AZ 86326-5828
(928) 646-7228
(928) 634-7288
Mailing address
4234 E WESTERN DR, COTTONWOOD, AZ 86326-5828
(928) 646-7228
(928) 634-7288
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08002289A
IN
111N00000X
Chiropractor
Primary
8311
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200856870A
—
IN
01
—
250100C
MEDICARE
IN
Enumeration date
11/15/2006
Last updated
03/30/2016
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