Provider Demographics
NPI:1124350020
Name:SOREN, JARON R (DC)
Entity type:Individual
Prefix:DR
First Name:JARON
Middle Name:R
Last Name:SOREN
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 1:309 E LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-4863
Mailing Address - Country:US
Mailing Address - Phone:208-455-0678
Mailing Address - Fax:208-455-0679
Practice Address - Street 1:309 E LOGAN ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4863
Practice Address - Country:US
Practice Address - Phone:208-455-0678
Practice Address - Fax:208-455-0679
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor