Provider Demographics
NPI:1578609665
Name:JARY, EUGENE JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:JOSEPH
Last Name:JARY
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 1:27527 JOY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5503
Mailing Address - Country:US
Mailing Address - Phone:734-522-5501
Mailing Address - Fax:734-522-0339
Practice Address - Street 1:27527 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5503
Practice Address - Country:US
Practice Address - Phone:734-522-5501
Practice Address - Fax:734-522-0339
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950H241620OtherBLUE CROSS AND BLUE SHIELD OF MICHIGAN
MI1443612Medicaid
MIMI3654Medicare PIN
MI1443612Medicaid