Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 262577-1202 | UT |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 262577-1202 | UT |
NPI | 1356422828 |
---|---|
Provider Name | Stuart John Yeager |
First Address | Cottonwood Heights, UT 84121-3766 |
Second Address | Cottonwood Heights, UT 84121-3766 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 28/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000056218 | (02) | UT |
D6541 | (05) | UT |