Provider Demographics
NPI:1578587481
Name:ARNDORFER, JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:ARNDORFER
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 1:12871 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8255
Mailing Address - Country:US
Mailing Address - Phone:515-224-0050
Mailing Address - Fax:
Practice Address - Street 1:12871 UNIVERSITY AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8255
Practice Address - Country:US
Practice Address - Phone:515-224-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08307OtherWELLMARK
IAU98717Medicare UPIN
IAI11200Medicare PIN