Provider Demographics
NPI:1578753471
Name:GARWOOD, JASON PATRICE (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:PATRICE
Last Name:GARWOOD
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 1:5092 CAHABA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3502
Mailing Address - Country:US
Mailing Address - Phone:205-222-7387
Mailing Address - Fax:
Practice Address - Street 1:5092 CAHABA VALLEY RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-3502
Practice Address - Country:US
Practice Address - Phone:205-981-8081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51104605OtherBCBS
AL51541452OtherBLUE CROSS BLUE SHIELD OF
AL51104605OtherBCBS