Provider Demographics
NPI:1205018686
Name:MANIN, JASON BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRIAN
Last Name:MANIN
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 1:4124 CADENA RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4625
Mailing Address - Country:US
Mailing Address - Phone:940-222-6264
Mailing Address - Fax:
Practice Address - Street 1:4401 N I 35 UNIT 103
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-3433
Practice Address - Country:US
Practice Address - Phone:940-222-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor