Organization
SOUTH JORDAN CHIROPRACTIC, LLC
Active
Other names
Pain to Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R. JAY SHETLIN DC (MEMBER)
(801) 446-5100
Entity
Organization
Contact information
Practice address
10456 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 446-5100
Mailing address
10456 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 446-5100
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
374015-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508947367
NPI
UT
Enumeration date
11/25/2008
Last updated
02/11/2009
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