Healthcare Provider Details

I. General information

NPI: 1356422828
Provider Name (Legal Business Name): STUART JOHN YEAGER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7086 HIGHLAND DR SUITE 50
COTTONWOOD HEIGHTS UT
84121-3766
US

IV. Provider business mailing address

7086 HIGHLAND DR SUITE 50
COTTONWOOD HEIGHTS UT
84121-3766
US

V. Phone/Fax

Practice location:
  • Phone: 801-943-3355
  • Fax:
Mailing address:
  • Phone: 801-943-3355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number262577-1202
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number262577-1202
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: