Healthcare Provider Details

I. General information

NPI: 1982998951
Provider Name (Legal Business Name): JASON CARLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 UNIVERSITY BLVD E STE 202
SILVER SPRING MD
20903-3706
US

IV. Provider business mailing address

1011 UNIVERSITY BLVD E STE 202
SILVER SPRING MD
20903-3706
US

V. Phone/Fax

Practice location:
  • Phone: 301-434-0808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number501974
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: