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Individual
DR. JARRED RYAN COLEGROVE
Active
Individual
DR. JARRED RYAN COLEGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
812
WV
111N00000X
Chiropractor
Primary
CHIR007628
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2513506
—
ND
05
—
3810000793
—
WV
01
—
550785922
WORKERS COMP
WV
01
—
550785922005
BC BS
—
01
—
7668546
AETNA
—
01
—
8538660
CIGNA
—
01
—
WV00812
HEALTHPLAN
—
Enumeration date
08/09/2005
Last updated
09/20/2012
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