Provider Demographics
NPI:1669858585
Name:HALL, JARED VERNON (DC)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:VERNON
Last Name:HALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:682 S MAIN ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-6567
Mailing Address - Country:US
Mailing Address - Phone:435-799-3501
Mailing Address - Fax:435-787-1797
Practice Address - Street 1:1515 N 400 E
Practice Address - Street 2:SUITE 106
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7561
Practice Address - Country:US
Practice Address - Phone:435-787-1787
Practice Address - Fax:435-787-1797
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10110692-1202111N00000X
MN6084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor