Provider Demographics
NPI:1083854111
Name:HILL, JUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4747
Mailing Address - Country:US
Mailing Address - Phone:801-473-6097
Mailing Address - Fax:801-434-8333
Practice Address - Street 1:309 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4747
Practice Address - Country:US
Practice Address - Phone:801-473-6097
Practice Address - Fax:801-434-8333
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7225837-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor