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Contact Information

FUNCTIONAL ENDOCRINOLOGY CLINIC
10969 RIVER FRONT PKWY # 108
SOUTH JORDAN, UT84095-3538
 Phone: 435-862-0152
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor - Nutrition

111NN1001X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for FUNCTIONAL ENDOCRINOLOGY CLINIC

NPI Number 1922301365
LBN Legal business name FUNCTIONAL ENDOCRINOLOGY CLINIC
Authorized official JOSHUA REDD - (CHIROPRACTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/07/2010
Last updated 12/07/2010 - About 16 years ago
Identifiers
UT License # 5791354-1202
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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