Organization
DEXA BODY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON SHEPPARD (PRESIDENT/CEO)
(801) 428-8350
Entity
Organization
Contact information
Practice address
5263 S COMMERCE DR STE 201, MURRAY, UT 84107-5306
(801) 274-3392
(801) 274-3392
Mailing address
5263 S COMMERCE DR STE 201, SALT LAKE CITY, UT 84107-5306
(801) 274-3392
(801) 274-3392
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
05/07/2020
Last updated
06/18/2024
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