Provider Demographics
NPI:1104921436
Name:MARING, JASON ANDREW (DC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ANDREW
Last Name:MARING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JASON
Other - Middle Name:A
Other - Last Name:MARING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS, CCAC, DIPL AC
Mailing Address - Street 1:4312 MARY LYNN DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-1427
Mailing Address - Country:US
Mailing Address - Phone:515-988-8203
Mailing Address - Fax:515-330-2540
Practice Address - Street 1:2925 INGERSOLL AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-4035
Practice Address - Country:US
Practice Address - Phone:515-255-3021
Practice Address - Fax:515-274-8732
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIA14266Medicaid
IB1133OtherMEDICARE PTAN