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General NPI Number Information
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NPI Number | 1447193545
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Entity Type | Organization
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Legal Business Name | JSA NUTRITION
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 12966 S SPARROW HAWK LN
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City | HERRIMAN
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State | UT
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Zip | 84096-5735
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Country | US
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Telephone | 714-317-7065
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Fax |
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Provider Business Mailing Address
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Address Line | 138 E 12300 S # 282
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City | DRAPER
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State | UT
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Zip | 84020-7976
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Country | US
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Telephone | 714-317-7065
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADAM PARKER
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Credential |
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Telephone | 714-317-7065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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