| Healthsource Of West Jordan | |
|
1573 W 9000 S, West Jordan, UT 84088-9219 | |
| (801) 541-2902 | |
| Not Available |
| Full Name | Healthsource Of West Jordan |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1573 W 9000 S, West Jordan, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265279210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Richard Matthew Winn |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1437994845 PECOS PAC ID: 9830620814 Enrollment ID: I20241001003146 |
| Provider Name | Ryan Nieznanski Williams |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417768854 PECOS PAC ID: 1052821022 Enrollment ID: I20250609002655 |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of West Jordan 10509 S 2330 W, South Jordan, UT 84095-2609 Ph: Not Available | Healthsource Of West Jordan 1573 W 9000 S, West Jordan, UT 84088-9219 Ph: (801) 541-2902 |
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