Provider Demographics
NPI:1144572082
Name:PERTUSET, JARRED GLENN (DC)
Entity Type:Individual
Prefix:DR
First Name:JARRED
Middle Name:GLENN
Last Name:PERTUSET
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 1:945 COLD WATER DR # 945
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-2549
Mailing Address - Country:US
Mailing Address - Phone:937-205-1716
Mailing Address - Fax:
Practice Address - Street 1:6213 SNIDER RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2643
Practice Address - Country:US
Practice Address - Phone:513-754-0050
Practice Address - Fax:513-229-3740
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor