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General NPI Number Information
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NPI Number | 1841358710
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Entity Type | Individual
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Provider Name | SIDNEY JEREMY WESTERMAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 2195 W 5400 S SUITE 202
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City | TAYLORSVILLE
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State | UT
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Zip | 84118-1431
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Country | US
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Telephone | 801-966-2804
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Fax | 801-982-9234
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Provider Business Mailing Address
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Address Line | 8038 S STATE ST
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City | MIDVALE
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State | UT
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Zip | 84047-3243
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Country | US
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Telephone | 801-569-1250
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Fax | 801-567-1516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4875370-1202
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License Number State | UT
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