Provider Demographics
NPI:1154801058
Name:JN WADSWORTH
Entity type:Organization
Organization Name:JN WADSWORTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:WADSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-235-9944
Mailing Address - Street 1:730 S SLEEPY RIDGE DR STE 210
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84059-2614
Mailing Address - Country:US
Mailing Address - Phone:385-453-0009
Mailing Address - Fax:385-453-0199
Practice Address - Street 1:730 S SLEEPY RIDGE DR STE 210
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84059-2614
Practice Address - Country:US
Practice Address - Phone:385-453-0009
Practice Address - Fax:385-453-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10320622-1202111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty