Provider Demographics
NPI:1407283633
Name:PIERSON, JARED HYRUM (DC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:HYRUM
Last Name:PIERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JARED
Other - Middle Name:HYRUM
Other - Last Name:PIERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:11719 W BOLL BLOOM DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-7864
Mailing Address - Country:US
Mailing Address - Phone:602-405-2553
Mailing Address - Fax:
Practice Address - Street 1:4500 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-4907
Practice Address - Country:US
Practice Address - Phone:480-715-6112
Practice Address - Fax:480-715-6481
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor