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General NPI Number Information
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NPI Number | 1205051521
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Entity Type | Organization
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Legal Business Name | JARRETT CHIROPRACTIC & REHAB PA
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4000 WEST NORTHERN PARKWAY
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City | BALTIMORE
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State | MD
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Zip | 21215
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Country | US
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Telephone | 410-578-1490
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Fax | 410-578-1492
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Provider Business Mailing Address
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Address Line | 4000 WEST NORTHERN PARKWAY
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City | BALTIMORE
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State | MD
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Zip | 21215
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Country | US
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Telephone | 410-578-1490
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Fax | 410-578-1492
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Authorized Official
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Title or Position | PRESIDENT DOCTOR OF CHIROPRACTIC
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Name | SCOTT DAVID JARRETT
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Credential | DC
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Telephone | 410-578-1490
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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 | 501863
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License Number State | MD
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