Healthcare Provider Details
I. General information
NPI: 1003217449
Provider Name (Legal Business Name): ANDREW J REHEISSE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/04/2014
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1996 E 6400 S STE 260
MURRAY UT
84121-2173
US
IV. Provider business mailing address
7351 S UNION PARK AVE STE 150
MIDVALE UT
84047-1869
US
V. Phone/Fax
- Phone: 801-944-1855
- Fax: 385-351-5950
- Phone: 801-944-1855
- Fax: 385-351-5950
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 9123542-1202 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 9123542-1202 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: