Provider Demographics
NPI:1316159031
Name:JARRETT, MICHAEL SHAWN (CRT, LPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SHAWN
Last Name:JARRETT
Suffix:
Gender:M
Credentials:CRT, LPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 POPLAR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-8867
Mailing Address - Country:US
Mailing Address - Phone:731-986-0121
Mailing Address - Fax:
Practice Address - Street 1:915 POPLAR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-8867
Practice Address - Country:US
Practice Address - Phone:731-986-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other