Individual
DR. JARRED RYAN COLEGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1335 JUANITA AVE, GAINESVILLE, GA 30501-1725
(770) 535-0550
(770) 535-1007
Mailing address
1335 JUANITA AVE, GAINESVILLE, GA 30501-1725
(770) 535-0550
(770) 535-1007
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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