Provider Demographics
NPI:1902929888
Name:SEFA, JASON J (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:J
Last Name:SEFA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 SHELDON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1418
Mailing Address - Country:US
Mailing Address - Phone:810-513-1703
Mailing Address - Fax:
Practice Address - Street 1:137 SHELDON AVE
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-1418
Practice Address - Country:US
Practice Address - Phone:810-513-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor