Provider Demographics
NPI:1396850343
Name:RICHER, JASON D
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:D
Last Name:RICHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 DOGWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1622
Mailing Address - Country:US
Mailing Address - Phone:515-401-2303
Mailing Address - Fax:
Practice Address - Street 1:13435 UNIVERSITY AVE
Practice Address - Street 2:150
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8249
Practice Address - Country:US
Practice Address - Phone:515-226-2155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor