Jason Scott Abbott
Student in an Organized Health Care Education/Training Program in Phoenix, AZ. Individual provider (NPI-1).
NPI number1184257958
StatusActive
Last updated in NPPESMar 24, 2021
Details
- NPI
- 1184257958
- Entity type
- Individual (NPI-1)
- Name
- Jason Scott Abbott
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2020
- Certification date
- Mar 24, 2021
- Last updated
- Mar 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
1919 E Thomas RdPhoenix, AZ 85016-7710
Phone 602-933-0945
Mailing address
7243 Madison St Apt 205Forest Park, IL 60130-3727
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