Individual
DR. JOHN JOSEPH COLARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12571 S PASTURE ROAD, SUITE E, RIVERTON, UT 84096-7037
(801) 878-3645
(801) 878-3647
Mailing address
12571 S PASTURE ROAD, SUITE E, RIVERTON, UT 84096-7037
(801) 878-3645
(801) 878-3647
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5072634-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000061848
MEDICARE GROUP PTAN
UT
Enumeration date
11/23/2006
Last updated
05/02/2008
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