Basic Information
| Provider Information | |||||||||
| NPI: | 1831102904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCWILLIAMS | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | EUGENE | ||||||||
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| Credential: | ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10843 BROOKLAWN RD | ||||||||
| Address2: | |||||||||
| City: | HIGHLANDS RANCH | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801306631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037899974 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8200 E BELLEVIEW AVE STE 615 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801112808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036943333 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.