Provider Demographics
NPI:1821987686
Name:LEPAGE, JASON (PT, DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LEPAGE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BECKER AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1902
Mailing Address - Country:US
Mailing Address - Phone:401-644-3429
Mailing Address - Fax:
Practice Address - Street 1:1005 MAIN ST UNIT 2201
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-7809
Practice Address - Country:US
Practice Address - Phone:401-644-3429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT037452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic