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General NPI Number Information
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NPI Number | 1629231287
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Entity Type | Organization
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Legal Business Name | WATTS LLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 1972 W 5400 S
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City | TAYLORSVILLE
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State | UT
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Zip | 84118-1459
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Country | US
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Telephone | 801-613-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1972 W 5400 S
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City | TAYLORSVILLE
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State | UT
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Zip | 84118-1459
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Country | US
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Telephone | 801-613-4500
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JAY DEVIN WATTS
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Credential | D.C.
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Telephone | 801-631-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 51882401202
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License Number State | UT
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