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General NPI Number Information
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NPI Number | 1760473516
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Entity Type | Individual
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Provider Name | JASON RICHARD MENGES D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 516 BALTIMORE PIKE
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City | BEL AIR
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State | MD
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Zip | 21014
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Country | US
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Telephone | 410-638-2424
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Fax | 410-893-8923
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Provider Business Mailing Address
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Address Line | 1416 MARTIN MEADOWS DR
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City | FALLSTON
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State | MD
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Zip | 21047-2221
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Country | US
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Telephone | 410-877-1597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01933
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License Number State | MD
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