Individual
JESSE ADAM CLEVERLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1684 W REUNION AVE STE 250, SOUTH JORDAN, UT 84095-4626
(801) 562-0363
(801) 562-0347
Mailing address
1684 W REUNION AVE STE 250, SOUTH JORDAN, UT 84095-4626
(801) 562-0363
(801) 562-0347
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9213627-1202
UT
111N00000X
Chiropractor
CHIA-851
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010008123
BLUE SHIELD
ID
05
—
806192200
—
ID
Enumeration date
02/08/2007
Last updated
12/16/2014
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