Provider Demographics
NPI:1043540388
Name:DOWELL, JARED (DC)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:DOWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 E 5900 S
Mailing Address - Street 2:STE. 100
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5421
Mailing Address - Country:US
Mailing Address - Phone:801-261-1700
Mailing Address - Fax:
Practice Address - Street 1:279 E 5900 S
Practice Address - Street 2:STE. 100
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5421
Practice Address - Country:US
Practice Address - Phone:801-261-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4945832-1202111N00000X
AZ8102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor