Provider Demographics
NPI:1922546118
Name:CROW, JARED (DC)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:CROW
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 1:606 E BOONESLICK RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383
Mailing Address - Country:US
Mailing Address - Phone:636-400-3213
Mailing Address - Fax:636-238-2898
Practice Address - Street 1:606 E BOONESLICK RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383
Practice Address - Country:US
Practice Address - Phone:636-400-3213
Practice Address - Fax:636-238-2898
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
MO2024032566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer