Provider Demographics
NPI:1497723191
Name:BANNING, CALE JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CALE
Middle Name:JONATHAN
Last Name:BANNING
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 1:215 N WARRIOR LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8313
Mailing Address - Country:US
Mailing Address - Phone:515-978-0333
Mailing Address - Fax:515-978-0334
Practice Address - Street 1:215 N WARRIOR LN
Practice Address - Street 2:SUITE A
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8313
Practice Address - Country:US
Practice Address - Phone:515-978-0333
Practice Address - Fax:515-978-0334
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA39069OtherBLUE CROSS BLUE SHIELD
IA39069OtherBLUE CROSS BLUE SHIELD
IAU97375Medicare UPIN