Healthcare Provider Details

I. General information

NPI: 1316159031
Provider Name (Legal Business Name): MICHAEL SHAWN JARRETT CRT, LPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 POPLAR SPRINGS RD
HUNTINGDON TN
38344-8867
US

IV. Provider business mailing address

915 POPLAR SPRINGS RD
HUNTINGDON TN
38344-8867
US

V. Phone/Fax

Practice location:
  • Phone: 731-986-0121
  • Fax:
Mailing address:
  • Phone: 731-986-0121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: