Provider Demographics
NPI:1770506503
Name:SCHLICHTE, JASON M (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:SCHLICHTE
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 1:3420 59TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3608
Mailing Address - Country:US
Mailing Address - Phone:515-210-4343
Mailing Address - Fax:515-289-0424
Practice Address - Street 1:6633 NW 6TH DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-1008
Practice Address - Country:US
Practice Address - Phone:515-289-0400
Practice Address - Fax:515-289-0424
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor