Provider Demographics
NPI:1689492555
Name:STRUYDE, JARED L (LMT)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:L
Last Name:STRUYDE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROSLYN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4634
Mailing Address - Country:US
Mailing Address - Phone:978-864-8938
Mailing Address - Fax:
Practice Address - Street 1:111 CANAL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4649
Practice Address - Country:US
Practice Address - Phone:781-864-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA544847225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist