MEDICARE: NICHOLAS TAKIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	13352850-1202	UT

General Provider Information

NPI Number	:	1033986864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS TAKIS DC

Provider Business Mailing Address
First Line	:	10352 S RIVER HEIGHTS DR STE 102
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-9013
Country	:	US
Telephone Number	:	801-302-0301
Fax Number	:

Provider Business Practice Location Address
First Line	:	10352 S RIVER HEIGHTS DR STE 102
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-9013
Country	:	US
Telephone Number	:	801-302-0301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	01/20/2026

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Directions to “ NICHOLAS TAKIS DC” Practice Location

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