Provider Demographics
NPI:1861723561
Name:HUGHES, JASON (CMT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HUGHES
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SCAREY LN
Mailing Address - Street 2:APT. 3
Mailing Address - City:NORTH BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05257-9641
Mailing Address - Country:US
Mailing Address - Phone:518-232-7540
Mailing Address - Fax:
Practice Address - Street 1:532 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2875
Practice Address - Country:US
Practice Address - Phone:802-447-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist