Provider Demographics
NPI:1548808116
Name:VOLLWEILER, JASON MICHAEL (PTA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:MICHAEL
Last Name:VOLLWEILER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LANDINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-2027
Mailing Address - Country:US
Mailing Address - Phone:561-722-2288
Mailing Address - Fax:
Practice Address - Street 1:901 45TH ST
Practice Address - Street 2:KIMMEL BLDG
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-844-5255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant