Individual
DR. JASON R CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
3614 E SOUTHERN AVE # A-105, MESA, AZ 85206-2509
(480) 863-3448
(480) 863-6202
Mailing address
5705 E HAMPTON CIR, MESA, AZ 85206-6746
(480) 747-3102
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8011
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3784
PHYSIO THERAPY LICENSE#
AZ
01
—
7205204
AETNA PROVIDER
AZ
01
—
8011
LICENSE#
AZ
01
—
AZ0937301
BCBS PROVIDER NO
AZ
Enumeration date
05/31/2006
Last updated
04/05/2023
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