J Brinton Andersen, DC
Individual provider Active NPI Chiropractor · South Jordan, UT
NPI 1134465271 · NPPES record last updated Dec 18, 2012
Key facts
- NPI
- 1134465271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 7965217-1202 (UT)
- Practice address
- 10965 S River Front Pkwy
South Jordan, UT 84095-3538 - Phone
- (801) 380-4234
- NPI assigned
- Dec 18, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7965217-1202 | UT | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 7965217-1202 | UT | Yes |
Addresses
Primary practice location
10965 S River Front Pkwy
South Jordan, UT 84095-3538
Mailing address
10965 S River Front Pkwy
South Jordan, UT 84095-3538
Phone (801) 380-4234
Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.