Healthcare Provider Details

I. General information

NPI: 1063508570
Provider Name (Legal Business Name): JARED LEROY SPECHT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2721 BUFFALO GAP ROAD
ABILENE TX
79605
US

IV. Provider business mailing address

2721 BUFFALO GAP ROAD
ABILENE TX
79605
US

V. Phone/Fax

Practice location:
  • Phone: 325-692-2227
  • Fax: 325-692-2345
Mailing address:
  • Phone: 325-692-2227
  • Fax: 325-692-2345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8328
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: