Provider Demographics
NPI:1043378474
Name:PLEMON, JARED AUGUST (DC)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:AUGUST
Last Name:PLEMON
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 1:3620 HENRY STREET
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441
Mailing Address - Country:US
Mailing Address - Phone:231-780-9900
Mailing Address - Fax:231-780-9908
Practice Address - Street 1:3620 HENRY STREET
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441
Practice Address - Country:US
Practice Address - Phone:231-780-9900
Practice Address - Fax:231-780-9908
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor