Provider Demographics
NPI:1538509252
Name:EAST, JAY (DC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:EAST
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 1:232 STATE ST
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:IA
Mailing Address - Zip Code:50438-1122
Mailing Address - Country:US
Mailing Address - Phone:641-512-4553
Mailing Address - Fax:
Practice Address - Street 1:232 STATE ST
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:IA
Practice Address - Zip Code:50438-1122
Practice Address - Country:US
Practice Address - Phone:641-512-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073135111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor